The relation between health literacy, hypertension knowledge, and blood pressure among middle-aged Japanese adults

Blood Press Monit. 2011 Oct;16(5):224-30. doi: 10.1097/MBP.0b013e32834af7ba.


Background: With the growth in the popularity of the Internet, individuals' skills in finding and applying information about health issues [health literacy (HL)] are affecting their health behaviors. This study aimed to examine functional HL (FHL), critical HL (CHL), and hypertension knowledge (HK) among middle-aged Japanese adults. In addition, to measure health outcomes, we examined the relationship between HL, HK, and blood pressure (BP) level.

Methods: The study included middle-aged participants who received an annual health check-up at an urban clinic in Japan. FHL, CHL, and HK were assessed using structured questionnaires. In addition, BP was obtained from the electronic medical record.

Results: Participants included 139 women and 181 men with a mean age of 54.4 years (standard deviation = 0.69). Individuals with lower reading comprehension scores in FHL were more likely to have a history of hypertension (P = 0.003) and diabetes mellitus (P = 0.02). Individuals with lower CHL had significantly higher rates of current smoking (P = 0.03) and men with lower CHL had a significantly higher waist circumference (P = 0.03). There was a significant relationship between sex and HK (P = 0.03). Systolic BP in women with higher HL and HK was significantly lower than in men with higher FHL (P < 0.001), CHL (P = 0.01), and HK (P = 0.001).

Conclusion: Lower HL and HK were associated with a poor health status and BP level in middle-aged participants. Further research is needed to examine the role of health management in improving outcomes and to address disparities between individuals with higher and lower HL.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Asian People*
  • Blood Pressure*
  • Female
  • Health Behavior*
  • Health Knowledge, Attitudes, Practice
  • Health Literacy*
  • Health Status Disparities
  • Humans
  • Hypertension / physiopathology*
  • Japan
  • Male
  • Middle Aged
  • Obesity / complications