JMIR Publications

ABSTRACT

Background:

Hypertension represents a significant global health challenge, closely linked to cardiovascular diseases and elevated premature mortality rates. Prehypertension, defined as elevated blood pressure not meeting the diagnostic criteria for hypertension, necessitates early intervention to prevent disease progression. Health literacy, defined as the capacity to comprehend and utilize health-related information, is positively associated with better health outcomes.

Objective:

This study investigated the relationship between health literacy and prehypertension in adults in South Korea, aiming to identify how health literacy may influence the management and prevention of prehypertension. Although prior research has concentrated on health literacy in cardiovascular diseases, most have emphasized treatment adherence, behavioral enhancement, and patient outcomes. Furthermore, current health literacy assessment instruments are frequently designed for particular diseases or disadvantaged groups, without considering the broader health context. This study aimed to address the public health concern of prehypertension and its association with health literacy in South Korea, utilizing the most recent Korean population-based sample data to investigate affected subgroups and the correlation between health literacy deficiencies and the risk of prehypertension.

Methods:

Data were obtained from the 2023 Korea National Health and Nutrition Examination Survey, a nationally representative cross-sectional study. A stratified, multi-stage clustered sampling design was employed to invite participants. Adults aged 19 years and older who completed the health literacy assessment were included in the analysis. Health literacy was measured using the Korean Health Literacy Index. Prehypertension was defined as a systolic blood pressure of 130–139 mmHg or a diastolic blood pressure of 80–89 mmHg. A multivariable survey-weighted logistic regression model was employed to assess the association between health literacy and prehypertension, adjusting for sociodemographic and health-related co-variates.

Results:

Of the 1,873 participants, 319 (17%) had prehypertension, and 58.6% showed inadequate health literacy. After adjusting for confounders, those with low health literacy had a 43% higher likelihood of prehypertension (odds ratio: 1.43; 95% confidence interval: 1.07–1.91) than did those with high health literacy. This association was particularly strong among women, middle-aged adults, individuals with lower education levels, and those with healthy habits.

Conclusions:

A substantial association between low health literacy and prehypertension was observed. These findings highlight the importance of enhancing health literacy for the early management and prevention of hypertension. Further longitudinal studies are needed to confirm causal relationships and identify effective interventions.