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

Abstract

Hypertension is a major global health challenge, affecting more than 1 billion people worldwide, and this is projected to increase in 1.56 billion by 2025. 1,2 Uncontrolled hypertension is currently an important contributor for heart disease, stroke, kidney failure, and premature mortality. 3,4 Globally, hypertension is responsible for 13% of premature deaths in developed and developing countries. 3,5 According to an Iranian national survey in 2011, 25.6% of adults, aged 25-70 years, had hypertension. 6 Also, the crude incidence rate of hypertension was 33.6 per 1000 person-years in Iranian population, over a decade long follow-up. 7 A wide variety of genetic and environmental factors predispose individuals to hypertension; although, contribution of genetic factors has been shown to be small. 8 According to available evidence, a number of lifestyle behaviors including, smoking, diabetes, being obese or overweight, high cholesterol, excess salt intake, and physical inactivity play a greater role in developing hypertension. 9,10 Therefore, early detection of individuals at high risk for hypertension and proper management of these modifiable risk factors is important for primary prevention of hypertension. 9 One approach to investigate the contribution of environmental factors in disease development is study of cohabiting couples because such spouses usually are not genetically related but share a common living environment, pool resources, eat together, and share a social network. 11,12 A large number of epidemiological studies demonstrated significant positive spousal concordance for diabetes mellitus (DM), 13-16 and the majority of main coronary risk factors including diastolic blood pressure (DBP), triglycerides (TG), total and low-density lipoprotein cholesterol (TC and LDL-C), AbstractWe investigated the association between metabolic risk factors in one spouse with incident hypertension in the other. Study sample included 1528 men and 1649 women aged ≥20 years from the Tehran lipid and glucose study with information on body mass index (BMI), waist circumference (WC), hypertension, type 2 diabetes mellitus (DM), and dyslipidemia. The hazard ratio (HR) and 95% confidence interval (95% CI) were estimated for the association of spousal metabolic factors and incident hypertension among men and women separately. A total of 604 and 566 cases of incident hypertension were observed in men and women, respectively. Among men, spousal DM was associated with a 40% (CI: 1.07-1.83) excess risk of hypertension after adjusting for the men's own and their spouse's risk factors including BMI, DM, smoking, and physical activity level. Among women, spousal DM was associated with more than two times (2.11, 1.69-2.63) higher risk of hypertension. After further adjustment for the women's own and their spouse's risk factors, the association was attenuated and remained marginally significant (1.25, 0.99-1.58; P value = .053).Having a spouse with DM increases an individual's risk of hypertension, which raises the possibility of using pre...

Concordance of hypertension, diabetes and dyslipidaemia in married couples: cross-sectional study using nationwide survey data in Japan

“…Additionally, some cohort studies conducted in the Middle East have generated different results: having a wife with diabetes did not significantly increase her husband’s risk of diabetes, 19 and having a spouse with hypertension did not increase the risk of hypertension. 20 The establishment of a cohort study in Japan would allow us to evaluate this issue in more detail.…”

“…There have been several previous studies of the spousal concordance of disease, [12][13][14][15][16][17][18][19][20] and it has been posited that the degree of spousal concordance depends on the community being studied. 16 In Japan, to the best of our knowledge, no studies have been conducted using nationally representative data regarding the spousal concordance of hypertension, diabetes or dyslipidaemia.…”

High genetic burden of type 2 diabetes can promote the high prevalence of disease: a longitudinal cohort study in Iran

“…Type 2 diabetes was diagnosed based on the fasting plasma glucose ≥ 126 mg/dL or 2-h plasma glucose ≥ 200 mg/dL during an oral glucose tolerance test 35 . The first occurrence of type 2 diabetes in individuals during the follow-up period was considered as diabetic condition 36 . The baseline characteristics of the participants were shown in Table 4.…”

Predictive value of women’s weight trajectories in determining familial cardiovascular disorders: a family-based longitudinal study

“…Several cross-sectional studies on spousal concordance have been conducted in chronic diseases, including hypertension 23 , 24 , cardiovascular diseases 25 , 26 , cancers, and type 2 diabetes 27 , which may be explained by the shared environment 22 . In Iran, the spousal concordance for type 2 diabetes and hypertension has been previously shown in cross-sectional studies 28 , 29 .…”