Health literacy and hypertension-related multimorbidity: unravelling the mediating role of self-management - insights from the lifelines cohort study

A change from limited health literacy to adequate health literacy had no direct effect on the onset of hypertension-related multimorbidity but did decrease the likelihood of its progression. Problem-solving indirectly mediated only the onset; meanwhile, motivation, self-efficacy beliefs and problem-solving mediated the progression of hypertension-related multimorbidity. Improving health literacy and self-management skills can play a crucial role in preventing or delaying the onset or progression of hypertension-related multimorbidity. These improvements can significantly reduce the disease burden for individuals with limited health literacy and those living with hypertension-related multimorbidity.