Paper studies concordant hypertension across four countries

December 6, 2023

Contact: Jon Meerdink ([email protected])

ANN ARBOR — A new study encompassing data from four countries shows that if one member of a couple has high blood pressure, the other member is likely to have high blood pressure as well.

Lindsay Kobayashi, Ph.D. and Chihua Li, Dr.PH., of the Institute for Social Research’s Survey Research Center, were among the authors on the paper “Spousal concordance of hypertension among middle-aged and older heterosexual couples around the world: evidence from studies of aging in the USA, England, China, and India.” In addition to the three non-U.S. countries, the paper drew on data from the Health and Retirement Study (HRS) at ISR.

“We found that the prevalence of spousal hypertension, or concordant hypertension, is very high across these four countries,” said Li. “In the U.S., around 38% of couples both have hypertension. In England it’s almost 47%. In China it’s 21% and in India it’s 20%.”

The paper also found that across all four countries, once one of the couple develops hypertension, their partner is also more likely to develop hypertension as well, primarily due to shared living environments as well as life and health behaviors.

In addition, Li notes that the the association between a husband and wife’s hypertension is stronger in India and China than the U.S. and England.

“We have two hypotheses for why that is. The first is that in western society, there’s an emphasis on individualism, so couples in the U.S., for instance, might tend to have different health behaviors than in Asian countries where collectivism is more important,” he said. “It may also be due to the fact that in the U.S. and England, the population is at a later stage of epidemiologic transition, which means chronic disease can be more prevalent.” 

The study differs from others on similar subjects due to its size; more than 30,000 couples were surveyed to collect the data that led to these findings. Additionally, the samples are constructed to be nationally representative, giving a big-picture view of the health of middle-age and older adults across all four countries in the data. 

The size becomes advantageous for applying the research to other findings. Examining health trends across countries can help identify trends that may not initially be easy to study.

“It gives us more power to detect differences within countries and between countries that can help us to identify risk factors that we can work on to reduce the disease burden.”

This paper was published in the Journal of the American Heart Association in December 2023. It was funded in part by contributions from the National Institutes of Health, which also produced the below video in summary of the study.

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