Health literacy skills and the benefits of cardiovascular disease prevention

Cardiovascular disease (CVD) prevention can be highly effective: the complete elimination of health risk behaviours could potentially prevent around 80% of CVDs (and 40% of cancers) [1, 2]. Most of the effective treatments are relatively simple (although they may require extraordinary discipline), and most of the drugs that are prescribed are generic and highly affordable. The greatest challenge is therefore in implementation of these preventive treatments. Consistently, surveys report low levels of adherence to lifestyle improvements and to medication, particularly in the long term. Even in secondary prevention, in patients who have experienced complications of CVD, adherence is disappointing [3]. Significant inequalities exist between countries and between ethnicities in the same country [4]. Among the many variables that impact on these patterns, socio-economic status is prominent. In this issue, Van Schaik et al. report on one of the elements associated with low socioeconomic status: low health literacy [5]. According to the World Health Organisation, health literacy is linked to literacy and entails people’s knowledge, motivation and competences to access, understand, appraise and apply health information in order to make judgements and take decisions in everyday life concerning healthcare, disease prevention and health promotion to maintain or improve quality of life during the life course [6]. The authors reviewed data from the RESPONSE 1 study, which randomised patients who had been discharged after an acute coronary syndrome to a nurse-led secondary pre-