Health Literacy in Patients With Acute Stroke Is Associated With Carotid Intima-Media Wall Thickness: A Cross-Sectional Study.

Background and purpose: The recurrence rate in patients with stroke is high, and arteriosclerosis is a significant risk factor for recurrent strokes. Health literacy, the ability to access, understand, and use information to promote and maintain health, is associated with various health risks. However, its association with atherosclerosis in patients with stroke remains unclear. Therefore, this study aimed to determine whether carotid intima-media wall thickness (CIMT), a marker of atherosclerosis, is associated with health literacy in patients with acute stroke.

Methods: This cross-sectional study included 207 patients (median age: 72 years) after their first stroke, excluding those with subarachnoid hemorrhage, admitted to an acute care hospital. The study variables were CIMT and health literacy. Mean CIMT was measured in the left and right common carotid arteries. Health literacy was assessed using the European Health Literacy Survey Questionnaire (HLS-EU-Q16), a shortened version of the European Health Literacy Survey Questionnaire 47. The correlation between mean CIMT and HLS-EU-Q16 score was analyzed.

Results: Mean CIMT was significantly negatively associated with the HLS-EU-Q16 score (r = -0.174, p = 0.012). Multiple regression analysis identified the HLS-EU-Q16 score as a factor associated with mean CIMT (β = -0.171, B = -0.005, 95% confidence interval: -0.009 to -0.001, p = 0.020).

Discussion: This study demonstrates that health literacy is associated with mean CIMT in patients with acute stroke, with those having low health literacy exhibiting a higher mean CIMT than their counterparts. Therefore, improving health literacy may be an important management strategy to prevent atherosclerosis and its progression in patients with stroke.