Relationship between e-health literacy, cyberchondria, and cardiovascular disease risk factors knowledge level in hypertension patients

Hypertension is a prevalent chronic condition and a significant modifiable risk factor for cardiovascular disease (CVD), with poor management increasing morbidity and mortality risks. The internet has become the primary source of health information, but limited e-health literacy can lead to misinterpretation of content, increased anxiety, and cyberchondria. Although there is a link between health anxiety, cyberchondria, and psychological distress, research on the effect of e-health literacy on these issues in relation to knowledge about cardiovascular risk factors in hypertensive patients is insufficient. Understanding this relationship is important because low e-health literacy can exacerbate anxiety and prevent effective management of cardiovascular risks.

The aim of this study is to examine the relationship between e-health literacy, cyberchondria severity and CVD risk factors knowledge level in hypertension patients.

This descriptive and correlational study was conducted between December 2024, and April 2025. The sample included 422 hypertension patients who met the inclusion criteria and were hospitalized in the cardiology ward or coronary care unit, or who attended the cardiology outpatient clinic. Data were collected using a "Personal Information Form," "E-Health Literacy Scale," "Cyberchondria Severity Scale (CCS)," and "Cardiovascular Disease Risk Factors Knowledge Level (CARRF-KL) Scale," and data analysis was undertaken using SPSS. Statistical significance was accepted at a level of p<0.05.

The mean age of the participants was 64.20±11.08, and 58.8% were male. The mean e-health literacy scale score was 25.77±10.20, the mean CCS was 25.97±10.62, and the mean CARRF-KL scale score was 18.81±4.44. The participants had a moderate level of e-health literacy, a low level of cyberchondria severity, and above-average knowledge of cardiovascular disease risk factors.

A positive correlation was found between e-health literacy scale scores and both CCS (r=0.58; p<0.05) and CARRF-KL scale scores (r=0.53; p<0.05). Additionally, CCS scores were positively correlated with CARRF-KL scale scores (r=0.44; p<0.05)

Multiple regression analysis showed that among people with hypertension, e-health literacy scale scores (β = 0.42, p < 0.05) and CCS scores (β = 0.19, p < 0.05) were both significant positive predictors of CARRF-KL scale scores. The effect of e-health literacy was approximately twice as strong as that of cyberchondria severity (ΔR² = 0.306).

This study revealed that as e-health literacy and cyberchondria severity increase in individuals with hypertension, knowledge about cardiovascular disease risk factors also increases, and that e-health literacy is approximately twice as strong a predictor in this relationship compared to cyberchondria.