Living Alone Increases the Risk of Hypertension in Older Chinese Adults: A Population-Based Longitudinal Study

Abstract

Background and Objectives Cross-sectional studies have suggested a potential association between living alone and hypertension risk, but longitudinal evidence remains limited. We aimed to investigate the correlation between living alone, alterations in living arrangements, and hypertension risk among older adults utilizing a population-based longitudinal design. Research Design and Methods The study included 8,782 older adults (≥65 years) without hypertension from the Chinese Longitudinal Healthy Longevity Survey. Participants were surveyed during the 2008 and 2011/2012 waves and were subsequently followed up in the next wave. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, or a self-reported diagnosis of hypertension by a physician. Cox proportional hazards model was used to explore the association between living alone and hypertension. Additionally, we analyzed how switching living arrangements during the follow-up period affects hypertension. Results During a median follow-up of 2.8 (1.7-3.0) years, 2,750 hypertension events occurred. Compared with living with family, the hazard ratio (HR) (95% confidence interval [CI]) of living alone was 1.19 (1.06-1.33) for hypertension. Similarly, persisting in living alone during follow-up increased the risk of hypertension compared to continuing to live with family (HR 1.24; 95% CI 1.06-1.45). Compared to married participants who continued to live with family, widowed/divorced participants who transitioned from living with family to living alone experienced a higher risk of hypertension (HR 1.21; 95% CI 1.00-1.47). Stratified analyses showed that living alone was only associated with an increased hypertension risk for participants aged >80, men, and rural residents. Discussion and Implications Living alone at baseline or persisting in living alone during follow-up correlated with increased hypertension risk. Divorced/widowed individuals who transitioned from living with family to living alone were still at risk. These results indicate that social support and living arrangements may be important in preventing hypertension in older adults.

Analysis of health risk factors for older adults living alone in China and establishment and evaluation of a nomogram prediction model

“…Their psychological well-being is associated with increased income and internet use. This may be because older adults with higher economic status can fulfill basic needs for food, shelter, and clothing, then pursue higher-level needs of healthy social and recreational activities to safeguard mental health, effectively alleviating feelings of helplessness and loneliness from loss of a spouse or children leaving home, and elevating positive emotions ( 7 , 34 ). Additionally, greater income implies solitary older adults can access and utilize more medical resources, reducing mental health risks.…”

“…Older individuals living alone, separated from their children or other family members, confront numerous challenges, including inconveniences, difficulties, and safety hazards in home-based care ( 6 , 7 ). A cohort study showed that living alone increases the risk of hypertension in older adults in China ( 7 ).…”

“…Older individuals living alone, separated from their children or other family members, confront numerous challenges, including inconveniences, difficulties, and safety hazards in home-based care ( 6 , 7 ). A cohort study showed that living alone increases the risk of hypertension in older adults in China ( 7 ). Moreover, research has illuminated that living alone, compared to cohabiting with family, is significantly associated with higher levels of depression ( 8 ).…”

“…Former research on the health status of solitary older adults in home-based care has centered largely on disparate regions ( 7 ), community care models ( 14 ) and support systems ( 15 ). While most of these studies addressed disease factors and nutritional status, they devoted less consideration to the connections between the health conditions of solitary seniors and elements like mandarin proficiency, digital literacy, health insurance coverage, and pension benefits, overlooking some critical information.…”

“…It is crucial to identify and mitigate health risks among older individuals living alone, providing them with appropriate medical services and support. Older individuals living alone, separated from their children or other family members, confront numerous challenges, including inconveniences, difficulties, and safety hazards in home-based care (6,7). A cohort study showed that living alone increases the risk of hypertension in older adults in China (7).…”