Couples who stay together get high BP together

3 minute read

What’s mine is yours.

Couple dressing is adorable, but matching blood pressure readings is taking it to an unhealthy level.  

The authors of this study published in the Journal of the American Heart Association set out to discover whether married couples, “who often have the same interests, living environment, lifestyle habits and health outcomes, may also share high blood pressure”, says co-lead author Dr Jithin Sam Varghese from Emory University in Atlanta.  

This isn’t a completely new hypothesis, but the study is the largest and most culturally diverse so far: they looked at blood pressure measures for 3989 American couples, 1086 English couples, 6514 Chinese couples and 22,389 Indian couples, using available datasets.  

They were all heterosexual couples middle-aged and older, and only one blood pressure reading (averaged from three taken at a single point in time) was recorded for each individual. They were deemed to have hypertension if they had either systolic blood pressure greater than or equal to 140mmHg, diastolic blood pressure greater than or equal to 90mmHg, or a recorded history of high blood pressure. 

The average length of the marriage or partnership was 30 years – plenty of time for habits to converge.  

Hypertension rates were high, ranging from 40% to 65% across the board, but was generally lower in women, with the greatest difference being in the US, where the rates were 54.5% for wives and 64.5% for husbands.  

“Considering the high prevalence of hypertension and the observed spousal concordance, our findings highlight the potential utility of couple-based interventions for hypertension diagnosis and management, such as couple-based screening, skills training, or joint participation in programs,” the authors write.  

If that sounds harder to sell to your spouse than marriage counselling, maybe join a tennis club.  

Prevalence of spousal concordance (both members of a partnership have hypertension) ranged from 20% in India and China to 40% in the US and 47% in England.  

But – and this is slightly counterintuitive, at least to your Back Page scribe – when they measured associations, i.e. whether wives with hypertensive husbands were more likely than wives without hypertensive husbands to have hypertension themselves, and the same with the sexes reversed, that effect size was greater in China and India, with no significant sex differences. 

This result “could be attributed to cultural differences between countries”, the authors write. “In Asian cultural contexts, collectivism is enshrined, and family members, including spouses, are encouraged to depend on each other, producing a stronger interpersonal relationship. In contrast, individualism emphasised by Western cultures promotes mutual independence and freedom.” 

For better, for worse, for richer, for poorer, in hypertension and in health, to love and to cherish, till stroke do us part?  

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