What causes concordance of hypertension between spouses in India? Identifying a critical knowledge gap from a nationally representative cross-sectional sample of 63,020 couples aged 15 + years
Abstract Background Hypertension, a critical risk factor for cardiovascular diseases, is found to cluster between spouses due to within-couple aggregation of antecedent environmental risk factors, either through assortative mating or cohabitation. However, majority of the evidence of spousal concord...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-023-16379-z |
| _version_ | 1797769306376765440 |
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| author | Gayatri Nayak Shishirendu Ghosal Jyoti Ghosal Ambarish Dutta |
| author_facet | Gayatri Nayak Shishirendu Ghosal Jyoti Ghosal Ambarish Dutta |
| author_sort | Gayatri Nayak |
| collection | DOAJ |
| description | Abstract Background Hypertension, a critical risk factor for cardiovascular diseases, is found to cluster between spouses due to within-couple aggregation of antecedent environmental risk factors, either through assortative mating or cohabitation. However, majority of the evidence of spousal concordance of hypertension is from Caucasoid couples from western societies, whereas marriage, partner selection, and post-marital roles of husband and wives are very different in Indian society. Therefore, we aimed to comprehensively examine the phenomenon of spousal concordance of hypertension in Indian couples. Method Couples from Longitudinal Ageing Study in India Wave 1 (n = 10,994) and National Family Health Survey Round 5 (n = 52,026) represented 15 years + Indian spouses. Hypertension was defined when systolic and/or diastolic blood pressure was > 139 and > 89 mmHg respectively, and/or if the individual was previously diagnosed or on anti-hypertensive medication. Odds Ratios (OR) estimated the within-couple concordance of hypertension while adjusting for five environmental risk factors of hypertension: individual-level body mass index, education and caste, and household-level wealth and place of residence. Result OR marginally attenuated from 1.84 (95% Confidence Interval: 1.77, 1.92) to 1.75 (1.68, 1.83) after adjustment, signifying negligible explanation by environmental risk factors, and plausibility of “novel” risk factors. Concordance continued to weaken with age (OR: 2.25 (2.02, 2.52) in < 30 versus 1.36 (1.20, 1.53) in ≥ 60 years). Conclusion Our study underscores two critical knowledge gaps: first, the identity of “novel” risk factors of hypertension and second, the mechanism behind weakening of concordance with age. Future research should explore these novel risk factors rigorously and try to modify them. Also, primary healthcare policy of the country should focus on couples in addition to individuals for hypertension and cardiovascular disease screening and management. |
| first_indexed | 2024-03-12T21:06:03Z |
| format | Article |
| id | doaj.art-68b931b3fd0c450e955240d038f75936 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-12T21:06:03Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-68b931b3fd0c450e955240d038f759362023-07-30T11:26:29ZengBMCBMC Public Health1471-24582023-07-0123111010.1186/s12889-023-16379-zWhat causes concordance of hypertension between spouses in India? Identifying a critical knowledge gap from a nationally representative cross-sectional sample of 63,020 couples aged 15 + yearsGayatri Nayak0Shishirendu Ghosal1Jyoti Ghosal2Ambarish Dutta3Tata Steel FoundationIndian Council of Medical Research—Regional Medical Research CentreIndian Council of Medical Research—Regional Medical Research CentreIndian Institute of Public Health, Public Health Foundation of IndiaAbstract Background Hypertension, a critical risk factor for cardiovascular diseases, is found to cluster between spouses due to within-couple aggregation of antecedent environmental risk factors, either through assortative mating or cohabitation. However, majority of the evidence of spousal concordance of hypertension is from Caucasoid couples from western societies, whereas marriage, partner selection, and post-marital roles of husband and wives are very different in Indian society. Therefore, we aimed to comprehensively examine the phenomenon of spousal concordance of hypertension in Indian couples. Method Couples from Longitudinal Ageing Study in India Wave 1 (n = 10,994) and National Family Health Survey Round 5 (n = 52,026) represented 15 years + Indian spouses. Hypertension was defined when systolic and/or diastolic blood pressure was > 139 and > 89 mmHg respectively, and/or if the individual was previously diagnosed or on anti-hypertensive medication. Odds Ratios (OR) estimated the within-couple concordance of hypertension while adjusting for five environmental risk factors of hypertension: individual-level body mass index, education and caste, and household-level wealth and place of residence. Result OR marginally attenuated from 1.84 (95% Confidence Interval: 1.77, 1.92) to 1.75 (1.68, 1.83) after adjustment, signifying negligible explanation by environmental risk factors, and plausibility of “novel” risk factors. Concordance continued to weaken with age (OR: 2.25 (2.02, 2.52) in < 30 versus 1.36 (1.20, 1.53) in ≥ 60 years). Conclusion Our study underscores two critical knowledge gaps: first, the identity of “novel” risk factors of hypertension and second, the mechanism behind weakening of concordance with age. Future research should explore these novel risk factors rigorously and try to modify them. Also, primary healthcare policy of the country should focus on couples in addition to individuals for hypertension and cardiovascular disease screening and management.https://doi.org/10.1186/s12889-023-16379-zConcordanceEnvironmentHypertensionSpousesIndia |
| spellingShingle | Gayatri Nayak Shishirendu Ghosal Jyoti Ghosal Ambarish Dutta What causes concordance of hypertension between spouses in India? Identifying a critical knowledge gap from a nationally representative cross-sectional sample of 63,020 couples aged 15 + years BMC Public Health Concordance Environment Hypertension Spouses India |
| title | What causes concordance of hypertension between spouses in India? Identifying a critical knowledge gap from a nationally representative cross-sectional sample of 63,020 couples aged 15 + years |
| title_full | What causes concordance of hypertension between spouses in India? Identifying a critical knowledge gap from a nationally representative cross-sectional sample of 63,020 couples aged 15 + years |
| title_fullStr | What causes concordance of hypertension between spouses in India? Identifying a critical knowledge gap from a nationally representative cross-sectional sample of 63,020 couples aged 15 + years |
| title_full_unstemmed | What causes concordance of hypertension between spouses in India? Identifying a critical knowledge gap from a nationally representative cross-sectional sample of 63,020 couples aged 15 + years |
| title_short | What causes concordance of hypertension between spouses in India? Identifying a critical knowledge gap from a nationally representative cross-sectional sample of 63,020 couples aged 15 + years |
| title_sort | what causes concordance of hypertension between spouses in india identifying a critical knowledge gap from a nationally representative cross sectional sample of 63 020 couples aged 15 years |
| topic | Concordance Environment Hypertension Spouses India |
| url | https://doi.org/10.1186/s12889-023-16379-z |
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