title: Hypertension status, treatment, and control among spousal pairs in a middle-aged adult cohort.
abstract: Hypertension status among spouses is known to be concordant, but previous studies relied on history rather than direct measurement, and few data exist on treatment and control between spouses. The goal of this study was to estimate the spousal association of hypertension status, treatment, and control in adults. The authors identified and analyzed data on 4,500 pairs from the Atherosclerosis Risk in Communities (ARIC) cohort, which sampled middle-aged adults and their spouses in 1986-1989, with 3 follow-up visits 3 years apart. Generalized estimating equations were used in logistic regression analyses to calculate the odds ratio of a spouse's being hypertensive on the basis of the other spouse's hypertension status across 4 visits, adjusting for age, race, body mass index, smoking status, and sodium intake in both individuals. There are marginally increased odds of hypertension for spouses married to someone with hypertension (odds ratio (OR) = 1.15, 95% confidence interval (CI): 1.06, 1.25). Treatment was positively associated between spouses (OR = 1.35, 95% CI: 1.10, 1.67). Control was suggestive of an association, although it was not statistically significant (OR = 1.21, 95% CI: 0.93, 1.56). In middle-aged adults, hypertension status and treatment were moderately associated between spouses after controlling for shared environment. Physicians may target hypertension education and prevention to spouses as a pair rather than as 2 separate patients.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. mmcadams@jhsph.edu
authors.forename: Mara
authors.initials: M
authors.lastname: McAdams DeMarco
authors.forename: Josef
authors.initials: J
authors.lastname: Coresh
authors.forename: Mark
authors.initials: M
authors.lastname: Woodward
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Butler
authors.forename: W H Linda
authors.initials: WH
authors.lastname: Kao
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Mosley
authors.forename: Michelle
authors.initials: M
authors.lastname: Hindin
authors.forename: Cheryl A M
authors.initials: CA
authors.lastname: Anderson
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D016015:Logistic Models; D008393:Marriage / Q000523:psychology / Q000706:statistics & numerical data*; D008875:Middle Aged; D012307:Risk Factors; D018454:Spouses / Q000523:psychology / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
chemical_list: D000959:Antihypertensive Agents