Spousal Concordance of Hypertension Among Middle‐Aged and Older Heterosexual Couples Around the World: Evidence From Studies of Aging in the United States, England, China, and India

• Type of Material: Article
• Authors: Jithin Sam Varghese, Emory University; Peiyi Lu, Columbia University; Daesung Choi, Emory University; Lindsay C. Kobayashi, University of Michigan; Mohammed K Ali, Emory University; Shivani A Patel, Emory University; Chihua Li, University of Michigan
• Language: English
• Date: 2023-12-06
• Publisher: American Heart Association
• Publication Version: Final Published Version
• Copyright Statement: © 2023 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://doi.org/10.1161/JAHA.123.030765
• Title of Journal or Parent Work: Journal of the American Heart Association
• Volume: 12
• Issue: 24
• Start Page: e030765
• Grant/Funding Information: Funding for this manuscript was provided by Emory Global Diabetes Research Center of Woodruff Health Sciences Center and Emory University. L.C. Kobayashi was supported by the National Institute on Aging (NIA) R01AG070953. S.A. Patel and M.K. Ali were supported by the National Heart, Lung, and Blood Institute P01HL154996‐01A1. C. Li was supported by NIA R01AG070953 and R01AG075719.
• Keywords: Risk Factors; Lifestyle; Epidemiology; spousal concordance; hypertension; cross‐national study; Aging; middle‐aged and older population; Women
• Research Categories: Sociology, Social Structure and Development; Health Sciences, Epidemiology

Abstract

Background Health concordance within couples presents a promising opportunity to design interventions for disease management, including hypertension. We compared the concordance of prevalent hypertension within middle‐aged and older heterosexual couples in the United States, England, China, and India. Methods and Results Cross‐sectional dyadic data on heterosexual couples were used from contemporaneous waves of the HRS (US Health and Retirement Study, 2016/17, n=3989 couples), ELSA (English Longitudinal Study on Aging, 2016/17, n=1086), CHARLS (China Health and Retirement Longitudinal Study, 2015/16, n=6514), and LASI (Longitudinal Aging Study in India, 2017/19, n=22 389). Concordant hypertension was defined as both husband and wife in a couple having hypertension. The prevalence of concordant hypertension within couples was 37.9% (95% CI, 35.8–40.0) in the United States, 47.1% (95% CI, 43.2–50.9) in England, 20.8% (95% CI, 19.6–21.9) in China, and 19.8% (95% CI, 19.0–20.5) in India. Compared with wives married to husbands without hypertension, wives married to husbands with hypertension were more likely to have hypertension in the United States (prevalence ratio, 1.09 [95% CI, 1.01– 1.17), England (prevalence ratio, 1.09, 95% CI, 0.98–1.21), China (prevalence ratio, 1.26 [95% CI, 1.17–1.35), and India (prevalence ratio, 1.19 [95% CI, 1.15–1.24]). Within each country, similar associations were observed for husbands. Across countries, associations in the United States and England were similar, whereas they were slightly larger in China and India. Conclusions Concordance of hypertension within heterosexual couples was consistently observed across these 4 socially and economically diverse countries. Couple‐centered interventions may be an efficient strategy to prevent and manage hypertension in these countries.