Study suggests a strong correlation between high blood pressure in spouses
A new study suggests that about half of middle-aged and older adults who have high blood pressure share or concordant cases with their spouses This means that if one spouse has high blood pressure, their partner is also likely to have it
A new study suggests that approximately half of hypertension cases in middle-aged and older adults are shared within couples, meaning that if one spouse has high blood pressure, their partner is likely to have it as well. The study, published in the Journal of the American Heart Association, found that among heterosexual couples in China, England, India, and the United States, there was a correlation between one partner having high blood pressure and the other also experiencing hypertension. Specifically, women married to men with high blood pressure were more likely to have hypertension themselves, and men married to women with high blood pressure were more likely to have hypertension compared to those whose spouses did not have high blood pressure.
The World Health Organization on Tuesday released its first report on the global impact of high blood pressure.
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The prevalence of high blood pressure among middle-aged and older adults in countries such as the US, England, China, and India is well-known. However, it was unexpected to discover that many older couples in these countries both have high blood pressure. For example, in the US, over 35% of couples aged 50 or older are both affected by hypertension," said Chihua Li, a post-doctoral fellow at the University of Michigan and an author of the study, in an email on Wednesday.
"Our study is the first to examine the occurrence of hypertension within couples from both high- and middle-income countries using nationally representative data, providing a cross-national perspective for comparison," Li added. "This is also the largest study on this topic conducted to date."
Researchers from the University of Michigan, Emory University, and Columbia University analyzed information from 1,086 couples in England, 3,989 couples in the United States, 6,514 couples in China, and 22,389 couples in India. The data, collected between 2015 and 2019, provided a snapshot of the couples' relationships. In the United States and England, the data included adults aged 50 and older and their spouses, while in China and India, it included adults aged 45 and older and their spouses.
The researchers used the average of three blood pressure measurements for each spouse to estimate overall systolic and diastolic blood pressure. A person was considered to have hypertension if they had a systolic blood pressure of 140 or greater, a diastolic blood pressure of 90 or greater, or a history of high blood pressure diagnosed by a health care provider. The study focused on determining the number of couples in the study who had "concordant hypertension," where both the husband and wife had high blood pressure.
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Researchers discovered a "high prevalence" of concordant hypertension in all four countries. Data indicated that 47.1% of couples in England, 37.9% in the United States, 20.8% in China, and 19.8% in India had concordant hypertension. "These findings indicate that approximately half of all cases of hypertension in these densely populated countries are concordant within couples," the researchers stated.
In all four countries, wives had a lower prevalence of hypertension than husbands. However, in China or India, if one spouse had hypertension, it was more likely that their partner did too, compared to couples in the United States and England. The researchers noted that these differences need to be further investigated and are likely due to a variety of factors, including cultural differences between countries. In Asian cultural contexts, couples may be more likely to share the same eating, exercise, and lifestyle habits, whereas in Western cultures, individualism is emphasized.
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"Hypertension is more prevalent in the United States and England compared to China and India. However, the link between the blood pressure of couples was found to be stronger in China and India than in the U.S and England. This could be attributed to cultural factors. In China and India, there is a strong emphasis on collective family unity, leading to a greater influence on each other's health within couples," explained Peiyi Lu, a co-lead author of the study and post-doctoral fellow in epidemiology at Columbia University Mailman School of Public Health. "In these collectivist societies, it is expected that couples rely on and support each other emotionally and practically, resulting in a more intertwined impact on health."
The researchers concluded that the high prevalence of concordant hypertension among couples in different countries provides a promising opportunity to develop ways for couples to manage the disease together, such as screening for high blood pressure, attending exercise classes, or cooking healthy meals as a couple.
"In cases where one or both partners have hypertension or are at higher risk, our study emphasizes the importance of discussing health with each other and using mutual influence and shared approaches for better hypertension management," Li mentioned in the email. "Strategies that focus on couples for diagnosis and management have the potential to make a significant impact. Specifically, joint monitoring, exercise programs, and shared lifestyle changes can all be implemented."
Dr. Bibhu Mohanty, an associate professor at the University of South Florida/Tampa General Hospital, noted that it's not uncommon for spouses' health status or behaviors to sometimes reflect each other. He cited smoking as a common example, stating that having a spouse who is a former smoker trying to quit can significantly impact the perspective of the other partner who is also trying to quit.
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"When trying to help someone quit smoking, the challenge is even greater when their spouse also smokes, as this creates a reinforcing cycle of bad habits," he explained. He noted that while hypertension is a medical condition, many of its common causes are behavioral, such as lack of regular exercise.
Similarly, exercising together or with one spouse already in the gym increases the likelihood of the other spouse continuing or initiating an exercise routine, said Mohanty. This link between behavior and tangible health outcomes, like blood pressure or weight, is intriguing and demonstrates the impact of behavioral factors on health.
