Abstract
The findings on the relationship between marital status and hypertension are inconsistent. We aimed to explore age differences in their associations. We used Hainan Hypertension Survey data, including 13,088 individuals aged more than 25 years, as part of the China Hypertension Survey study, a population-based nationwide study. The marital status was classified as following three groups: the unmarried, the married, and those who formerly lived with his/her spouse. We examined the association between marital status and blood pressure levels and the odds of hypertension across different ages and sex. The participants’ mean age was 49.9 ± 17 years, 49% were male, and 23% experienced hypertension. The multivariable logistic regression model showed among younger (<40 years) and older (≥60 years) participants, the married subjects appeared to have higher odds of hypertension compared with the unmarried counterparts, particular for men (Pheterogeneity = 0.039), after adjustment for age, sex, smoking, drinking, education background, employment situation, and body mass index. Compared with the unmarried and the married people, younger persons who previously had partners had a higher OR of hypertension than the older counterparts, and the ORs tended to decline with age (All Ptrend ≤ 0.005). The associations between marital status and blood pressure levels from multivariable linear regression models seemed consistent with the relationships mentioned above from logistic regression models. Our study indicates a marital status change is associated with a higher odds of hypertension, and it appears to be more obvious in young people.
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References
GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1789–858.
Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365:217–23.
Liu M, Li N, Li W, Khan H. Association between psychosocial stress and hypertension: a systematic review and meta-analysis. Neurological Res. 2017;39:573–80.
Wu X, Wang Z. Role of socioeconomic status in hypertension among chinese middle-aged and elderly individuals. Int J hypertension. 2019;2019:6956023.
Glover L, Cain-Shields L, Wyatt S, Gebreab S, Diez-Roux A, Sims M. Life course socioeconomic status and hypertension in African American Adults: the Jackson heart study. Am J hypertension. 2020;33:84–91.
Causland FR, Sacks FM, Forman JP. Marital status, dipping and nocturnal blood pressure: results from the Dietary Approaches to Stop Hypertension trial. J Hypertens. 2014;32:756–61.
Abu-Saad K, Chetrit A, Eilat-Adar S, Alpert G, Atamna A, Gillon-Keren M, et al. Blood pressure level and hypertension awareness and control differ by marital status, sex, and ethnicity: a population-based study. Am J Hypertens. 2014;27:1511–20.
Tayefi M, Esmaeili H, Saberi Karimian M, Amirabadi Zadeh A, Ebrahimi M, Safarian M, et al. The application of a decision tree to establish the parameters associated with hypertension. Comput Methods Prog Biomed. 2017;139:83–91.
Schwandt HM, Coresh J, Hindin MJ. Marital status, hypertension, coronary heart disease, diabetes, and death among african american women and men: incidence and prevalence in the atherosclerosis risk in communities (ARIC) study participants. J Fam Issues. 2010;31:1211–29.
Tuoyire D, Ayetey H. Gender differences in the association between marital status and hypertension in Ghana. J Biosoc Sci. 2019;51:313–34.
Ramezankhani A, Azizi F, Hadaegh F. Associations of marital status with diabetes, hypertension, cardiovascular disease and all-cause mortality: a long term follow-up study. PLoS One. 2019;14:e0215593.
Perkins JM, Lee HY, James KS, Oh J, Krishna A, Heo J, et al. Marital status, widowhood duration, gender and health outcomes: a cross-sectional study among older adults in India. BMC Public Health. 2016;16:1032.
Li Z, Fu C, Yang F, Mao Z. Prevalence and risk factors of hypertension for the middle-aged population in China - results from the China Health and Retirement Longitudinal Study (CHARLS). Clin Exp Hypertens. 2019;41:80–86.
Wang Z, Chen Z, Zhang L, Wang X, Hao G, Zhang Z, et al. Status of hypertension in China: results from the China hypertension survey, 2012-2015. Circulation. 2018;137:2344–56.
Wang Z, Zhang L, Chen Z, Wang X, Shao L, Guo M, et al. Survey on prevalence of hypertension in China: background, aim, method and design. Int J Cardiol. 2014;174:721–3.
Chen Z, Wang X, Wang Z, Zhang L, Hao G, Dong Y, et al. Assessing the validity of oscillometric device for blood pressure measurement in a large population-based epidemiologic study. J Am Soc Hypertens. 2017;11:730–36 e4.
Liu LS. Writing Group of Chinese Guidelines for the Management of H. [2010 Chinese guidelines for the management of hypertension]. Zhonghua Xin Xue Guan Bing Za Zhi. 2011;39:579–615.
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39:3021–104. 2018
Manfredini R, De Giorgi A, Tiseo R, Boari B, Cappadona R, Salmi R, et al. Marital status, cardiovascular diseases, and cardiovascular risk factors: a review of the evidence. J Women’s Health (Larchmt). 2017;26:624–32.
Oh WS, Yoon S, Noh J, Sohn J, Kim C, Heo J. Geographical variations and influential factors in prevalence of cardiometabolic diseases in South Korea. PLoS One. 2018;13:e0205005.
MM F. Filling the glass_ gender perspectives on families.pdf. J Marriage Fam. 2010;72:420–39.
Law R, Sbarra D. The effects of church attendance and marital status on the longitudinal trajectories of depressed mood among older adults. J aging health. 2009;21:803–23.
James GD. Ambulatory blood pressure variation: allostasis and adaptation. Auton Neurosci. 2013;177:87–94.
Landsbergis P, Schnall P, Pickering T, Warren K, Schwartz J. Life-course exposure to job strain and ambulatory blood pressure in men. Am J Epidemiol. 2003;157:998–1006.
Acknowledgements
We would like to thank the staff of Fuwai Hospital for their training in the investigation work and all the people who took part in the Hainan Hypertension Survey.
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Li, K., Ma, X., Yuan, L. et al. Age differences in the association between marital status and hypertension: a population-based study. J Hum Hypertens 36, 670–680 (2022). https://doi.org/10.1038/s41371-021-00558-9
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DOI: https://doi.org/10.1038/s41371-021-00558-9