New study finds many couples around the world may share high blood pressure

December 10, 2023

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New study finds many couples around the world may share high blood pressure

This is an interesting study, not just for what it says about blood pressure, which is interesting, but also something quite separate, which I will explain later.

If one spouse or partner in a heterosexual couple has high blood pressure, the other partner often does too, according to the new research published in the Journal of the American Heart Association.

What the researchers say: “Many people know that high blood pressure is common in middle-aged and older adults, yet we were surprised to find that among many older couples, both husband and wife had high blood pressure in the U.S., England, China and India,” the lead author said. “For instance, in the U.S., among more than 35% of couples who were ages 50 or older, both had high blood pressure.”

Researchers investigated whether heterosexual partners in the U.S., England, China and India mirrored each other’s high blood-pressure status. Previous studies have explored the union of high blood pressure and other diseases among couples in a single country setting or used small regional samples.

“Ours is the first study examining the union of high blood pressure within couples from both high- and middle-income countries,” the researchers noted. “We wanted to find out if many married couples who often have the same interests, living environment, lifestyle habits and health outcomes may also share high blood pressure.”

The researchers analyzed blood pressure measures for 3,989 U.S. couples, 1,086 English couples, 6,514 Chinese couples and 22,389 Indian couples and found:

• The prevalence of both spouses or partners having high blood pressure was about 47% in England; 38% in the U.S.; 21% in China and 20% in India.

• Compared to wives married to husbands without high blood pressure, wives whose husbands had high blood pressure were 9% more likely to have high blood pressure in the U.S. and England, 19% more likely in India and 26% more likely in China.

• Within each country, similar associations were observed for husbands. The association was consistent when the analyses were stratified by area of residence within each country, household wealth, length of marriage, age groups and education levels.

“High blood pressure is more common in the U.S. and England than in China and India, however, the association between couples’ blood pressure status was stronger in China and India than in the U.S and England. One reason might be cultural. In China and India, there’s a strong belief in sticking together as a family, so couples might influence each other’s health more,” said study’s lead researcher. “In collectivist societies in China and India, couples are expected to depend on and support each other, emotionally and instrumentally, so health may be more closely entwined.”

These findings highlight the potential of using couple-based approaches for high blood pressure diagnosis and management, such as couple-based screening, skills training or joint participation in programs, he noted.

• Couples were defined as heterosexual participants living in the same household who reported to be married or partnered to one another, and those who were older than legal age for marriage for their country at the time of the survey.

• The average age of husbands in the study was 65.7 years in the U.S.; 74.2 years in England; 61.5 in China; and 57.2 years in India. The average age of wives in the study was 62.9 years in the U.S; 72.5 years in England; 59.2 years in China and 51.1 years in India.

• High blood pressure was defined based on measurements at one time point. Participants were noted as having hypertension if they had one of the following: systolic blood pressure higher than 140 mm Hg or diastolic greater than 90 mm Hg, as measured by health professionals; or if they answered yes when asked if they had a history of high blood pressure.

• Among the study’s limitations were its cross-sectional design, meaning it captured a single point in time and thus only one blood-pressure measurement, and that the surveys included only heterosexual couples.

According to the American Heart Association’s 2023 statistics, in 2020, nearly 120,000 deaths were primarily attributable to high blood pressure, and from 2017 to 2020, 122.4 million (46.7%) U.S. adults had high blood pressure.

The findings are important because hypertension is among the most dominant modifiable cardiovascular risk factors and remains highly prevalent and poorly controlled on an increasingly global level. As the authors point out, the current focus of clinical and public health strategies to control hypertension on the individual level is not adequate. The authors suggest that interventions that target spouses may, thus, be especially effective.

“Following this idea, making lifestyle changes, such as being more active, reducing stress or eating a healthier diet, can all reduce blood pressure; however, these changes may be difficult to achieve and, more importantly, sustain if your spouse or partner (and greater family unit) are not making changes with you,” she said. “These findings also hint at a broader approach —interventions using a socioecological model considering determinants of hypertension across individual, interpersonal, environmental and policy levels are likely going to be necessary to reduce the global public health burden of hypertension.”

So, what? It has been shown in numerous studies over the last few years that we are attracted to those with whom we share genetic, behavioral and personality traits. The more commonality in these areas, the stronger the bond.

In terms of high blood pressure, it is an interesting question, in the light of this research, which comes first: do we fall into the same bad patterns as our partner and develop hypertension, or are is part of the attraction due to us sharing a propensity to the affliction?

Alicia and I both share a blood pressure reading under the magic mean of 120/80. Is this one of the reasons our marriage has lasted 40 years?

This research is about the dangers of couples sharing hypertension, but it may really be about the dynamics of human attraction.

Dr Bob Murray

Bob Murray, MBA, PhD (Clinical Psychology), is an internationally recognised expert in strategy, leadership, influencing, human motivation and behavioural change.

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