Association of health literacy with elevated blood pressure: a cohort study of hospitalized patients.
Association of health literacy with elevated blood pressure: a cohort study of hospitalized patients.
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DOI：
10.1097/mlr.0000000000000101
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发表时间：
2014-04
期刊：
影响因子：
3
通讯作者：
Roumie CL
中科院分区：
文献类型：
--
作者：
McNaughton CD;Kripalani S;Cawthon C;Mion LC;Wallston KA;Roumie CL
健康素养低的临床后果还没有得到充分的理解。我们评估了低健康素养与医院就诊时血压升高之间的关系。我们对2010年11月1日至2012年4月30日期间在大学医院住院的成人患者进行了横断面评估。健康素养评估使用简要健康素养屏幕（BHLS）。低健康素养定义为BHLS评分≤9。使用临床测量评估BP。结局为住院时血压升高（≥140/90 mmHg;糖尿病或肾脏疾病≥130/80 mmHg）或血压极度升高（>160/100 mmHg）。多变量logistic回归校正了年龄、性别、种族、保险、合并症和抗高血压药物;对诊断为高血压的患者进行了预先计划的限制性分析。在46，263例住院患者中，23%的患者健康素养较低，与BHLS>9的患者相比，年龄较大（61岁vs 54岁）、受教育程度较低（28.4% vs 11.2%未完成高中学业）的患者更常见，并且更常通过急诊科入院（54.3% vs 48.1%）。血压升高在健康知识水平低的人群中更常见（40.0%对35.5%;调整后的比值比[aOR] 1.06，95%CI 1.01，1.12）。健康知识水平低与血压极高（aOR 1.08，95% CI 1.01，1.16）和未诊断为高血压的患者血压升高（aOR 1.09，95% CI 1.02，1.16）相关。超过1/3的患者在医院就诊时血压升高。低健康素养与血压升高独立相关，特别是在未诊断为高血压的患者中。
The clinical consequences of low health literacy are not fully understood. We evaluated the relationship between low health literacy and elevated blood pressure (BP) at hospital presentation. We conducted a cross-sectional evaluation of adult patients hospitalized at a university hospital between November 1, 2010 and April 30, 2012. Health literacy was assessed using the Brief Health Literacy Screen (BHLS). Low health literacy was defined as a BHLS score ≤9. BP was assessed using clinical measurements. The outcome was elevated BP (≥140/90 mmHg; ≥130/80 mmHg with diabetes or renal disease) or extremely elevated BP (>160/100 mmHg) at hospital presentation. Multivariate logistic regression adjusted for age, gender, race, insurance, comorbidities, and antihypertensive medications; pre-planned restricted analysis among patients with diagnosed hypertension was performed. Of 46,263 hospitalizations, 23% had low health literacy, which occurred more often among patients who were older (61 vs. 54 years), less educated (28.4% vs. 11.2% had not completed high school), and more often admitted through the emergency department (54.3% vs. 48.1%) than those with BHLS>9. Elevated BP was more frequent among those with low health literacy (40.0% versus 35.5%; adjusted Odds Ratio [aOR] 1.06, 95%CI 1.01, 1.12). Low health literacy was associated with extremely elevated BP (aOR 1.08, 95% CI 1.01, 1.16) and elevated BP among those without diagnosed hypertension (aOR 1.09, 95% CI 1.02, 1.16). More than 1/3 of patients had elevated BP at hospital presentation. Low health literacy was independently associated with elevated BP, particularly among patients without diagnosed hypertension.