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

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.