Abstract

Objective: Psychological stress was a potential risk factor for hypertension, but the association between specific chronic stressors and female hypertension remains unclear. We examined the potential associations between the psychological stress within the family and female hypertension. Design and method: Reproductive-aged females along with their husbands from the National Free Pre-pregnancy Checkup Projects in 2016 and 2017 were recruited. The stress of wives and husbands was collected by a 5-point Likert-type scale, assessed by two domains: work/life-related stress and economic-related stress. Overall stress was defined as the higher stress level of work/life stress and economic stress. To include categories in the analysis with sufficient numbers of persons, this variable was recoded into four categories as follows: 1 = not stressed at all, 2 = slightly stressed, 3 = moderately stressed and 4 = a lot or extremely stressed. Hypertension was defined as systolic BP/diastolic BP > = 140/90 mm Hg or self-reported history of hypertension. Age-adjusted and multiple-covariates-adjusted logistic regression models were used to assess the associations between multiple types of stress statuses and hypertension. Results: Of 10 027 644 couples, 261 098 (2.60%) females were hypertension. The median age of wives was 27 (24–32) years and husbands 29 (26–34) years.1 574 191 (15.7%) wives feel stressed and 1 807 480(18.0%) husbands feel stressed. The stressor of 734 095 (7.32%) wives and 878 887 (8.76%) husbands was work/life, and 1 400 973 (14.0%) wives and 1722 007(17.2%) husbands economic. The results showed that the higher stress level wives or husbands had, the higher prevalence of female hypertension was found (Pfor trend < 0.001). Compared with the unstressed participants, wives or husbands with the highest stress level had the highest risk of female hypertension, with adjusted ORs of 1.28(95%CI:1.23 to 1.34) and 1.23(95%CI:1.18 to 1.27), respectively. After further adjustment for female stress, slightly stressed husbands decreased the risk of female hypertension [OR:0.96(95%CI: 0.94 to 0.97)]. Consistent trends were also observed in economic-stressed groups and life/work-stressed groups. Conclusions: Not only stress of wives but also moderate or severe stress of husbands within the family indicates a higher risk of female hypertension. A family-based stress-relieving program may help improve hypertension control in females.

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