Background

Cardiovascular complications are the main causes of death for type 2 diabetes. Their relationship to socioeconomic factors, such as health literacy, is not well known.

Objectives

To study the relationship between health literacy and cardiovascular complications (acute myocardial infarction, cerebrovascular accident, transient ischemic attack and ischemic heart disease) in type 2 diabetes patients and to understand the relationship of type 2 diabetes mellitus associated cardiovascular disease with empowerment and therapy adherence.

Material and methods

A cross-sectional study with a convenience sample of people with type 2 diabetes in central Portugal. Socio--demographic and clinical characteristics (blood pressure, LDL cholesterol, hemoglobin A1c and history of cardiovascular diseases) were collected, and validated scales were applied to assess health literacy, adherence to therapy, empowerment and quality of life. Bivariate inferential analysis between literacy, other variables and cardiovascular diseases, with subsequent Logistic Regression, was performed.

Results

A sample of n = 202, mean age 68.11 ± 10.19 years, n = 116 (57.4%) males was studied. Higher health literacy was significantly associated with a lower prevalence of cardiovascular diseases (p = 0.015). This relationship was independent of the remaining variables (OR = 0.947; 95% CI: 0.913–0.982; p = 0.003). Significant relationships were demonstrated between cardiovascular disease and quality of life (p = 0.001), adherence to total therapy (p = 0.045), general diet (p = 0.002), physical activity (p = 0.027), age (p = 0.004) and LDL cholesterol (p = 0.036).

Conclusions

The independent relationship between health literacy and cardiovascular disease in people with type 2 diabetes, when confirmed, will indicate that health literacy promotion acts as an important health policy measure to be adopted.