Spousal concordance for hypertension: A meta‐analysis of observational studies

Abstract

The authors performed a meta-analysis of observational studies to estimate the magnitude of spousal concordance for hypertension and to examine whether the concordance varied by important study methodological aspects. PubMed and Embase were searched up to June 2017 for cross-sectional, case-control, and cohort studies that investigated the concordance/association of hypertension between spouse pairs. A meta-analysis with random-effects models was performed by pooling adjusted odds ratios. Eight studies with a total number of 81 928 spouse pairs were eligible. The pooled results showed that spouses of individuals with hypertension had 41% (odds ratio, 1.41; 95% confidence interval, 1.21-1.64) increased odds of having hypertension themselves. The association applied to both men and women, and was not significantly different between studies with adjustment for body mass index and those without. The findings highlighted the importance of environmental factors in the development of hypertension. | INTRODUCTIONHypertension is the leading risk factor for morbidities and mortalities caused by cardiovascular and kidney diseases. The Global Burden Project estimated that hypertension accounts for 9.4 million deaths each year worldwide.1 Hypertension is a complex disorder resulting from both genetic and environmental determinants. and body mass index (BMI), spousal diagnosis of hypertension was the strongest risk factor of hypertension for men and second strongest risk factor for women, with adjusted risk estimates at two-to three-fold. 7 In another community-based population study in Brazil, however, the spousal association was not significant after adjusting for age. 9 Therefore, these inconsistencies and uncertainties need to be addressed using quantitative and comparative methods.Previous meta-analyses have observed a significant positive spousal concordance for diabetes mellitus and the majority of main coronary risk factors. 15,16 However, no meta-analysis has summarized the available evidence of spousal concordance for hypertension. In addition, the mechanism through which spousal concordance operates was not known. The concordance may operate through the Zhancheng Wang and Wenhui Ji contributed equally to this work.

Spousal metabolic risk factors and incident hypertension: A longitudinal cohort study in Iran

“…12 Although in our study we observed a positive correlation between couples for the baseline SBP, we did not find an elevated risk of hypertension incidence associated with spousal hypertension in both sexes. This meta-analysis found no statistically significant difference between studies with adjustment for BMI and in those without; as a results, the association was unlikely due to assortative mating, because, observed association did not strongly reduce when adjustment for BMI (a surrogate for assortative mating) was made.…”

“…This meta-analysis found no statistically significant difference between studies with adjustment for BMI and in those without; as a results, the association was unlikely due to assortative mating, because, observed association did not strongly reduce when adjustment for BMI (a surrogate for assortative mating) was made. 12 Although in our study we observed a positive correlation between couples for the baseline SBP, we did not find an elevated risk of hypertension incidence associated with spousal hypertension in both sexes.…”

“…17,18 A case-control study of couples aged >30 years showed that spouses of hypertensive patients had a twofold increased risk of hypertension beyond the effect of age, BMI, and DM. 12 Although a few studies have assessed cross-sectional associations of hypertension with spousal risk factors, to our knowledge, no prospective study has investigated the relation between spousal risk factors with incident hypertension. 12 Although a few studies have assessed cross-sectional associations of hypertension with spousal risk factors, to our knowledge, no prospective study has investigated the relation between spousal risk factors with incident hypertension.…”

“…19 A meta-analysis of eight observational studies, including one case-control, and seven cross-sectional studies found that spouses of individuals with hypertension had increased odds of having hypertension. 12 Although a few studies have assessed cross-sectional associations of hypertension with spousal risk factors, to our knowledge, no prospective study has investigated the relation between spousal risk factors with incident hypertension. Hence, we undertook the present study with the aim of studying this association in a large sample of Iranian couples over 18 years of follow-up in the Tehran lipid and glucose study (TLGS) cohort.…”

Why spouses depress each other: A cross‐national study to test the shared resource hypothesis in depressive symptom concordance within older adult couples

“…Health concordance is generally defined as similarity or strong correlation between the couples' health status (Meyler, Stimpson, & Peek, ). Studies have suggested that spouses resemble each other in physical health (Stimpson, Peek, & Markides, ; Wang et al, ), mental health (Ruthig, Trisko, & Stewart, ), health behavior (Lee et al, ), and medical utilization (Kendler, Lönn, Salvatore, Sundquist, & Sundquist, ). A majority of these studies concerning health concordance utilized empirical evidence from surveys targeting older adults.…”