Abstract 17353: Health Literacy and Hypertension: A Systematic Review

Introduction: Low health literacy (HL) is highly prevalent in the United States. Despite the potential for low HL to be a major barrier to effective self-management of blood pressure (BP), data on HL among adults with hypertension (HTN) is scarce.

Goals: We conducted a systematic review to examine the prevalence and factors associated with low HL among adults with HTN. Additionally, we examined intervention trials which sought to modify the impact of low HL among participants with HTN.

Methods: A comprehensive search of 6 databases was performed to identify studies which measured HL using a validated survey and included adults with HTN. After removing duplicate citations, two authors independently reviewed the references for eligibility, data extraction, and risk of bias assessment.

Results: A total of 1,046 studies were identified of which 44 met eligibility criteria. The prevalence of low HL was 33% among the 31,507 participants included across the 44 studies. In the studies that reported associations between social determinants of health factors and HL, lower education levels, non-white race, and lower HTN knowledge were found to be significantly associated with lower HL among adults with HTN. Among the 15 observational studies which examined BP, lower HL was associated with higher BP in 8 studies. Six randomized control trials included an intervention to modify HL and measure its effect on BP control. Two of these trials demonstrated significant reductions in BP among the intervention group compared to control.

Conclusion: Among studies which measured HL in adults with HTN, education, HTN knowledge and race were associated with HL; however, interventions to address HL were not consistently associated with improvements in BP control. A more detailed examination of methods to address HL among adults with HTN is warranted.