Journal of Public Health

, Volume 26, Issue 5, pp 551–558 | Cite as

The association between sex, age and health literacy and the uptake of cardiovascular prevention: a cross-sectional analysis in a primary care setting

  • Alessa Tschaftary
  • Natascha Hess
  • Sarah Hiltner
  • Sabine Oertelt-PrigioneEmail author
Original Article



As the incidence of cardiovascular diseases is rising worldwide, prevention measures for the general population become increasingly important. Herein we aim at identifying social determinants associated with the willingness to engage in prevention and healthy lifestyle choices.

Subject and methods

A total of 1,056 (70% response rate) of the patients attending a cardiology/primary care practice in the urban area of Berlin, Germany, were recruited to fill out a questionnaire for this cross-sectional survey. Patients provided sociodemographic and health literacy information, described their attitude towards prevention and lifestyle choices, as well as hurdles and requests towards measure design.


Sex, age and health literacy emerged as prime influencers of preventative choices. Sex differences affected the attendance of screening measures and lifestyle choices, although no differences emerged in attitude towards prevention between women and men. Low health literacy consistently associated with consideration of healthy lifestyle changes, but not with active engagement in them. Men more freqeuntly reported a need for clear explanation of the utility of prevention by their physicians (44% vs 37%) and low health literacy correlated with an increased request for free or subsidized offers (56% vs 44%). Time constraint was the most frequently mentioned hurdle (32%) for attendance, followed by costs (19%).


Sex, age and health literacy affect engagement in healthy lifestyle choices and expectations towards preventative measure design. Consideration of these differences will allow better tailoring of preventative offers to the users’ needs to increase their uptake.


Sex differences Prevention Cardiovascular Subgroup Hurdles Design 



The institutional ethics committee approved the study (internal identification number EA4/074/14).

Compliance with ethical standards

Conflict of interest

S.O.P. reports funding by the German Ministry of Education and Research (BMBF), Charité Foundation, the Equal Opportunity Fund of the City of Berlin and the Hans-Böckler Stiftung. S.O.P. has received a speaker’s honorarium from Pfizer. None of the other authors has any conflict of interest to declare.

Supplementary material

10389_2017_888_MOESM1_ESM.docx (13 kb)
Supplementary table 1 (DOCX 12 kb)
10389_2017_888_MOESM2_ESM.docx (15 kb)
Supplementary table 2 (DOCX 14 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Praxis Dr Natascha HessBerlinGermany
  2. 2.Institute of Gender in MedicineCharité – UniversitätsmedizinBerlinGermany
  3. 3.Institute of Legal MedicineCharité-UniversitätsmedizinBerlinGermany
  4. 4.Department of Primary and Community CareRadboud University Medical CenterNijmegenThe Netherlands

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