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Global study reveals hypertension common amongst middle-aged couples

In a recent study published by the Journal of the American Heart Association, researchers comparatively assessed concordant hypertension prevalence in middle‐aged heterosexual couples living in England, the USA (US), India, and China.

Study: PDF/EPUB Tools Share Jump to Abstract METHODS RESULTS DISCUSSION Sources of Funding Disclosures Footnotes References eLetters Supplemental Material Spousal Concordance of Hypertension Amongst Middle‐Aged and Older Heterosexual Couples Across the World: Evidence From Studies of Aging in the USA, England, China, and India. Image Credit: kurhan/


Hypertension or elevated blood pressure (BP) is a world public health issue, especially amongst nations with low or middle-level income. Early detection and treatment might help lower the disease burden. Spousal health concordance, defined as comparable health status between partnered or married couples, offers a chance to develop interventions to detect and control hypertension at a pair level.

Interpersonal risk amongst couples is quantified in studies, which could inform screening, preventive, and treatment approaches. International comparison studies with nationally representative sample populations stratified by gender may increase the accuracy and generalizability of study findings, resulting in more practical treatments for hypertension detection and management on the couple level.

Concerning the study

In the current cross-sectional study, researchers analyzed concordant hypertension prevalence amongst heterosexual partners in population-based studies conducted across England, the US, India, and China. Additionally they examined association strengths, comparing wives to husbands and the differences within the association across nations.

The sample population comprised 3,989 couples from the USA Health and Retirement Study (HRS) 2016-17 aged ≥18 years; 1,086 couples who participated within the English Longitudinal Study on Aging (ELSA) study 2016-17; 6,514 couples (husbands aged ≥22 years and wives aged ≥20 years) from the China Health and Retirement Longitudinal Study (CHARLS) 2015-16; and 22,389 couples (husbands aged ≥21 years and wives aged ≥18 years) in India from the Longitudinal Aging Study in India (LASI) 2017-19.

The researchers analyzed dyadic data on heterosexual couples from the 4 studies to find out the rates of concordant hypertension, described as each wife and husband having hypertension. The Gateway to the Global Aging Data staff from Southern California University harmonized data.

All 4 studies obtained data using household surveys by initially enrolling eligible primary participants after which requesting spouse/partner participation. The ELSA and HRS surveyed individuals aged ≥50, whereas the LASI and CHARLS surveyed those aged ≥45 and their partners, no matter age.

Participants with hypertension were identified by having systolic BP of 140 mm  Hg or higher, diastolic BP of 90 mm of Hg or higher, or high BP history, and drugs prescriptions were only asked of those that self-documented hypertension. The team analyzed individual-level health and sociodemographic characteristics, including age, education, and employment status, as conventional risk aspects for hypertension.

Health-associated patient characteristics included excessive alcohol intake, moderate-intensity physical exertion, and body mass index (BMI). Household characteristics, comparable to wealth, expenditures, variety of members, children, marriage length, and residence region, were considered potential confounders. Poisson regression modeling was performed, and prevalence ratios (PRs) were calculated.


The mean participant age ranged between 51 years (India) and 73 years (England) amongst wives and between 57 years (India) and 74 years (England) amongst husbands. Across nations, hypertension prevalence amongst wives was lower than amongst husbands, with a maximum difference in US couples (55% for wives vs. 65% for husbands). Concordant hypertension prevalence within the US, England, China, and India were 38%, 47%, 21%, and 20%, respectively.

The team observed positive associations of concordant hypertension for husbands and wives in each nation. In comparison with wives with non-hypertensive husbands, wives with hypertensive husbands showed an increased likelihood of getting hypertension within the US, England, China, and India. In comparison with husbands with non-hypertensive wives, husbands with hypertensive wives showed an increased likelihood of being hypertensive within the US, England, China, and India.

The team noted similar associations in England and the US but association differences of upper magnitude in India and China. Similar results were obtained after adjusting for individual, household, and spouse-related characteristics, with no differences in evaluations stratified by wealth quintile, residence, marriage duration, level of education, and age.

Overall, the study findings showed high prevalent rates of hypertension (20% to over 40%) amongst middle-aged heterosexual partners in England, the US, India, and China. The findings indicate that couple-centered interventions may be effective in stopping and managing hypertension in these nations.

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