title: The relation between health literacy, hypertension knowledge, and blood pressure among middle-aged Japanese adults.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Health Care Services Management, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Shibuya
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Inoue
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohkubo
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Takeda
authors.forename: Takeo
authors.initials: T
authors.lastname: Teshima
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imai
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kondo
mesh_terms: D044466:Asian People; D001794:Blood Pressure; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D054624:Health Status Disparities; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007564:Japan; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications