Prevalence of husband, wife duos with high blood pressure varies globally
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Key takeaways:
- Concomitant hypertension between heterosexual couples was observed in various countries.
- The phenomenon was most prevalent in India and China, but odds were still elevated in the U.S. and England.
One spouse in a heterosexual marriage having hypertension was associated with increased likelihood for the other spouse to have it as well, especially in India and China, but odds were also elevated among couples in the U.S. and England.
“Ours is the first study examining the union of high blood pressure within couples from both high- and middle-income countries,” Jithin Sam Varghese, PhD, assistant research professor at the Emory Global Diabetes Research Center at Emory University, said in a press release. “We wanted to find out if many married couples who often have the same interests, living environment, lifestyle habits and health outcomes may also share high blood pressure.”
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Varghese and colleagues used data from the U.S. Health and Retirement Study of 3,989 couples, the English Longitudinal Study on Aging of 1,086 couples, the China Health and Retirement Longitudinal Study of 6,514 couples and the Longitudinal Aging Study in India of 22,389 couples to compare the concordance of hypertension among heterosexual couples in each country.
The study was published in the Journal of the American Heart Association.
Concordant hypertension was defined as both husband and wife having hypertension.
Concordant high BP among married couples
The mean age ranged from 51 years in India to 73 years in England among wives and 57 years in India to 74 years in England among husbands.
The prevalence of hypertension among wives was lower compared with husbands across all four countries, with the largest difference observed among U.S. couples (54.5% for wives vs. 64.5% for husbands). The prevalence of concordant hypertension within couples was 37.9% in the U.S., 47.1% in England, 20.8% in China and 19.8% in India.
Compared with wives married to husbands without hypertension, wives married to a husband with hypertension were more likely to have hypertension in each country:
- U.S. (prevalence ratio [PR] = 1.09; 95% CI, 1.01-1.17);
- England (PR = 1.09; 95% CI, 0.98-1.21);
- China (PR = 1.26; 95% CI, 1.17-1.35); and
- India (PR = 1.19; 95% CI, 1.15 -1.24).
Similarly, compared with husbands married to wives without hypertension, husbands married to a wife with hypertension were also more likely to have hypertension in each country:
- U.S. (PR = 1.06; 95% CI, 1-1.13);
- England (PR = 1.05; 95% CI, 0.96-1.16);
- China (PR = 1.26; 95% CI, 1.18-1.35); and
- India (PR = 1.2; 95% CI, 1.12-1.28).
The results remained consistent after adjustment for individual, spousal and household characteristics such as BMI and age, according to the study.
“High blood pressure is more common in the U.S. and England than in China and India, however, the association between couples’ blood pressure status was stronger in China and India than in the U.S and England. One reason might be cultural. In China and India, there’s a strong belief in sticking together as a family, so couples might influence each other’s health more,” Peiyi Lu, PhD, postdoctoral fellow in epidemiology at Columbia University Mailman School of Public Health, said in the release. “In collectivist societies in China and India, couples are expected to depend and support each other, emotionally and instrumentally, so health may be more closely entwined.”
Importance of ‘mutual influence’
In a related editorial, Elvira D’souza, member of the patient editorial board for the Journal of the American Heart Association, discussed stronger associations between concordant hypertension in India and China as well the significance of these findings from a patient viewpoint.
“The study showed a slightly stronger concordance in China and India compared with the United States and England,” D’souza wrote. “The study alludes to possible cultural differences, with collectivism in Asian cultures promoting stronger interpersonal relationships as a possible reason. However, it would be interesting to see future studies address the mechanisms and possible causes of concordance.
“This study brings to light a unique approach to the diagnosis and management of hypertension and elevates the power of spousal partnerships in health care,” she wrote. “From a patient viewpoint, this study highlights the importance of having health-related conversations with partners and using mutual influence and shared approaches for better hypertension management. Couple-centered strategies for diagnosis and management has the potential to have significant impact, especially in countries where hypertension is emerging as a public health challenge.”
References:
- D’souza E. J Am Heart Assoc. 2023;doi:10.1161/JAHA.123.033064.
- New study finds many couples around the world may share high blood pressure. https://newsroom.heart.org/news/new-study-finds-many-couples-around-the-world-may-share-high-blood-pressure. Published Dec. 6, 2023. Accessed Dec. 6, 2023.
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