A study across four different countries has shown that it is common for both individuals in a couple to have high blood pressure, with experts saying that health strategies should target spouses to have the most impact.

Similar, previous studies have been carried out within a single country – this was the first to look at high blood pressure in heterosexual couples from both high and middle income countries.

Co-lead author Dr Jithin Sam Varghese, an assistant research professor at Emory University in Atlanta, explained: “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 studied blood pressure measurements for 3,989 U.S. couples, 1,086 English couples, 6,514 Chinese couples and 22,389 Indian couples.

Senior author Chihua Li, from the University of Michigan, said: “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.

“For instance, in the U.S., among more than 35% of couples who were ages 50 or older, both had high blood pressure.”

In England, around 47% of couples shared high blood pressure. The figure for the U.S. was 38%; 21% in China and 20% in India.

Study co-lead author Peiyi Lu, from Columbia University Mailman School of Public Health, explained: “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. In collectivist societies in China and India, couples are expected to depend and support each other, emotionally and instrumentally, so health may be more closely entwined.”

The study also showed that wives in the U.S. and England whose husbands had blood pressure were 9% more likely to have the condition too, compared to women whose husbands did not have high blood pressure. This figure was 19% in India and 26% in China.

Similar links were seen for husbands in each country.

Commenting on the findings, Bethany Barone Gibbs, an associate professor and chair of the department of epidemiology and biostatistics at the School of Public Health at West Virginia University, said: “Varghese, Lu and colleagues report an important finding among middle-aged and older adults – if your spouse has hypertension, you are more likely to have hypertension, too.

“These 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.”

Read the study in the Journal of the American Heart Association.

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