High blood pressure linked among couples in global research

Evidence of hypertension concordance among heterosexual couples worldwide: Insights from aging studies.

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New research from December 6, 2023, in Dallas, shows that if one person in a straight couple has high blood pressure, the other likely does too. This discovery comes from a study published in the Journal of the American Heart Association. 

The research, led by Chihua Li from the University of Michigan, found that in the U.S., England, China, and India, many older couples, when one partner has high blood pressure, the other does as well. For example, in the U.S., over 35% of couples aged 50 or older both had high blood pressure. The study examined whether partners in these countries had similar high blood pressure. Previous studies focused on one country or used small groups.

Study co-lead author Jithin Sam Varghese, Ph.D., an assistant research professor at the Emory Global Diabetes Research Center at Emory University in Atlanta, said, “Ours is the first study examining the union of high blood pressure within couples from both high- and middle-income countries. We wanted to determine if many married couples with the same interests, living environment, lifestyle habits, and health outcomes may also share high blood pressure.”

The researchers studied blood pressure in couples in the U.S., England, China, and India. They looked at 3,989 U.S. couples, 1,086 English couples, 6,514 Chinese couples, and 22,389 Indian couples. Here’s what they found:

  • In England, about 47% of couples had both partners with high blood pressure.
  • In the U.S., it was 38%.
  • In China, it was 21%.
  • In India, it was 20%.

If a husband had high blood pressure:

  • In the U.S. and England, wives were 9% more likely to have high blood pressure.
  • In India, they were 19% more likely.
  • In China, they were 26% more likely.

Similar patterns were found for husbands in each country. The link between partners’ blood pressure was consistent across different factors like where they lived, wealth, marriage length, age, and education.

“High blood pressure is more common in the U.S. and England than in China and India. However, the link between couples’ blood pressure is stronger in China and India than in the U.S. and England. One reason could be cultural. In China and India, there’s a strong belief in sticking together as a family so that couples might influence each other’s health more,” explained Dr. Peiyi Lu, a researcher at Columbia University Mailman School of Public Health. “In these societies, couples are expected to depend on and support each other emotionally and practically, making health more closely connected.”

“These findings suggest that couple-based approaches could help diagnose and manage high blood pressure. This could include screening both partners, providing skills training, or involving couples in joint health programs,” said Dr. Li.

In the study, researchers used data from various aging studies in the U.S., England, China, and India, including the 2016-17 Health and Retirement Study, the 2016-17 English Longitudinal Study on Ageing, the 2015-16 China Health and Retirement Longitudinal Study, and the 2017-19 Longitudinal Aging Study in India. These studies involved couples living in the same household, defined as heterosexual partners married or partnered, older than their country’s legal age for marriage.

The average ages of spouses varied across countries. High blood pressure was identified based on a single measurement, with participants considered to have hypertension if their blood pressure was consistently high or if they reported a history of high blood pressure.

The study has some limitations. It only took a snapshot in time, so each person had one blood pressure measurement. Additionally, it focused only on heterosexual couples.

In 2020, nearly 120,000 deaths were mainly because of high blood pressure, according to the American Heart Association’s 2023 statistics. From 2017 to 2020, about 46.7% of U.S. adults, 122.4 million people, had high blood pressure.

The researchers, including Varghese, Lu, and their colleagues, made an important discovery about middle-aged and older adults. If one spouse has high blood pressure, the other is more likely to have it.

“These findings are significant because high blood pressure is a major factor in heart health that can be changed, but it’s still a big problem worldwide. The current focus on treating high blood pressure individually may not be enough. They suggest that helping spouses make healthy changes could be incredibly effective,” explained Dr. Bethany Barone Gibbs from West Virginia University.

She added, “If both partners make lifestyle changes like being more active, reducing stress, or eating healthier, it can help lower blood pressure. But it’s hard to make and stick to these changes if your spouse or partner and your family aren’t making the same efforts. This study suggests we need a broader approach, using a model that considers factors like individual choices, relationships, the environment, and policies, to tackle the global high blood pressure problem.”

In conclusion, this study shows that high blood pressure is linked between couples worldwide. Working together as a couple to manage this health issue could be helpful. The study also says we must understand how culture affects our health behaviors and use complete strategies to deal with high blood pressure worldwide.

Journal reference:

  1. Jithin Sam Varghese, Peiyi Lu, 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. DOI: Journal of the American Heart Association. DOI: 10.1161/JAHA.123.030765.