Hypertension is a major global health challenge, affecting more than 1 billion people worldwide, and this is projected to increase in 1.56 billion by 2025. 1,2 Uncontrolled hypertension is currently an important contributor for heart disease, stroke, kidney failure, and premature mortality. 3,4 Globally, hypertension is responsible for 13% of premature deaths in developed and developing countries. 3,5 According to an Iranian national survey in 2011, 25.6% of adults, aged 25-70 years, had hypertension. 6 Also, the crude incidence rate of hypertension was 33.6 per 1000 person-years in Iranian population, over a decade long follow-up. 7 A wide variety of genetic and environmental factors predispose individuals to hypertension; although, contribution of genetic factors has been shown to be small. 8 According to available evidence, a number of lifestyle behaviors including, smoking, diabetes, being obese or overweight, high cholesterol, excess salt intake, and physical inactivity play a greater role in developing hypertension. 9,10 Therefore, early detection of individuals at high risk for hypertension and proper management of these modifiable risk factors is important for primary prevention of hypertension. 9 One approach to investigate the contribution of environmental factors in disease development is study of cohabiting couples because such spouses usually are not genetically related but share a common living environment, pool resources, eat together, and share a social network. 11,12 A large number of epidemiological studies demonstrated significant positive spousal concordance for diabetes mellitus (DM), 13-16 and the majority of main coronary risk factors including diastolic blood pressure (DBP), triglycerides (TG), total and low-density lipoprotein cholesterol (TC and LDL-C),
AbstractWe investigated the association between metabolic risk factors in one spouse with incident hypertension in the other. Study sample included 1528 men and 1649 women aged ≥20 years from the Tehran lipid and glucose study with information on body mass index (BMI), waist circumference (WC), hypertension, type 2 diabetes mellitus (DM), and dyslipidemia. The hazard ratio (HR) and 95% confidence interval (95% CI) were estimated for the association of spousal metabolic factors and incident hypertension among men and women separately. A total of 604 and 566 cases of incident hypertension were observed in men and women, respectively. Among men, spousal DM was associated with a 40% (CI: 1.07-1.83) excess risk of hypertension after adjusting for the men's own and their spouse's risk factors including BMI, DM, smoking, and physical activity level. Among women, spousal DM was associated with more than two times (2.11, 1.69-2.63) higher risk of hypertension. After further adjustment for the women's own and their spouse's risk factors, the association was attenuated and remained marginally significant (1.25, 0.99-1.58; P value = .053).Having a spouse with DM increases an individual's risk of hypertension, which raises the possibility of using pre...