Cardiovascular disease (CVD) is one of the largest contributors to disease burden worldwide, yet much of its risk is tied to modifiable factors. The Public Health Reports scoping review, “Health Literacy and Primary Prevention of Cardiovascular Disease,” examines what is currently known about the relationship between health literacy and a person’s risk of developing CVD and identifies where the evidence base still falls short.

Health literacy is thought to play a meaningful role in that prevention, but until now no review had mapped the full scope of the research connecting the two.

The review finds that of the 35 studies included, the large majority (74%) were cross-sectional, and most (60%) measured only functional health literacy, meaning basic reading and comprehension skills, rather than broader abilities like navigating the health system or critically evaluating health information. Several intervention studies pointed to a consistent pattern showing that, when health literacy support was built into the intervention, participants with lower baseline health literacy saw some of the largest gains in cardiovascular behaviors, such as improved diet and medication adherence.

The authors also note that associations between health literacy and objective CVD risk measures were inconsistent across studies due to differences in study design, suggesting this part of the evidence base is less settled than it may appear. The authors conclude that while several studies support a link between health literacy and CVD risk, more longitudinal research and more comprehensive health literacy measurement tools are needed to understand the relationship’s true extent.