The study by Varghese et al titled “Spousal Concordance of Hypertension Among Middle‐Aged and Older Heterosexual Couples Around the World: Evidence From Studies of Aging in the United States, England, China, and India” caught my attention for 2 reasons: (1) There are 3 cases of concordant hypertension in my immediate family, and (2) I have experienced first‐hand the benefits of shared hypertension management strategies with my spouse. 1 Before reading this paper, I had not actively thought about the prevalence of similar health conditions among partners as being related in any way. Additionally, I strongly believe that the approach of joint interventions could be an effective strategy for the diagnosis and management of hypertension.
The research delved into the spousal concordance of hypertension, drawing from nationally representative surveys of middle‐aged and older adults from 4 diverse countries: the United States, England, China, and India. The findings from this study revealed several key insights that highlight the importance of addressing hypertension as a shared concern among heterosexual couples.
A striking finding of the study was the high prevalence of concordant hypertension among heterosexual couples in these countries, ranging from 20% to 40%. These numbers indicate a significant public health burden. Given that the global burden of hypertension is increasing and that hypertension in older adults is related to adverse cardiovascular outcomes, 2 there is still a need to find additional strategies for hypertension management.
The second finding that stood out was that spousal concordance remains consistent across various socioeconomic subgroups, such as residence, education, and income. This suggests that the influence of one's spouse on hypertension status is not limited by demographic or economic factors. This finding could allow health care professionals to consider targeted interventions irrespective of these factors.
The idea of couple‐based interventions for hypertension diagnosis and management particularly stood out more because of how practical and easy to implement this approach is and the fact that these interventions could be implemented irrespective of socioeconomic factors. Health care practitioners who currently treat couples as separate patients should consider treating them as a unit and checking for hypertension in the other partner if one is diagnosed with the condition. The idea of partners working together to address a shared health concern opens up the possibility of using several interventions such as couple‐based screening, participation in joint programs, and recommending shared lifestyle changes and exercise plans that could be instrumental in managing hypertension more effectively.
From my own experience, scheduling doctor's appointments together, regularly monitoring blood pressure at home, exercising, and meal management has resulted in several benefits including an improvement in the quality of our lives. The ability to mutually influence health goals and the ability to celebrate small victories with these truly allows us to experience being together in sickness and health.
The disparities in spousal concordance across countries in the study are also noteworthy. The study showed a slightly stronger concordance in China and India compared with the United States and England. The study alludes to possible cultural differences, with collectivism in Asian cultures promoting stronger interpersonal relationships as a possible reason. However, it would be interesting to see future studies address the mechanisms and possible causes of concordance.
The findings of this study should also be of interest to health insurance providers, who could consider incentivizing couples to engage in joint preventive care and programs focused on lifestyle management as such measures could contribute to reducing health care costs in the long run. Public health agencies should use the findings of this study to increase awareness among families and couples on the prevalence of spousal concordance of hypertension and encouraging early diagnosis and prevention. Hypertension management guidelines could also include couple‐focused strategies.
In conclusion, this study brings to light a unique approach to the diagnosis and management of hypertension and elevates the power of spousal partnerships in health care. From a patient viewpoint, this study highlights the importance of having health‐related conversations with partners and using mutual influence and shared approaches for better hypertension management. Couple‐centered strategies for diagnosis and management has the potential to have significant impact, especially in countries where hypertension is emerging as a public health challenge (Figure).
Figure . Spousal concordance of hypertension and shared strategies for management.
HCP indicates health care practitioner. 1
Disclosures
None.
The opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.
Elvira D'souza is a member of JAHA's Patient Editorial Board. This Editorial is intended to provide a patient or caregiver perspective on the accompanying article.
See article by Varghese et al.
For Disclosures, see page 2.
References
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