Is an educated wife hazardous to your health?

Three of four previous studies have suggested that men whose wives are more educated than they are at increased risk of coronary heart disease, defined to include angina pectoris, but one study of coronary heart disease exclusive of angina failed to show an association with educational discordance. In this study, the authors used data from a cohort of 1698 spouse pairs aged 45-79 years who were followed prospectively for nine years to determine whether discordance for education was predictive of ischemic heart disease death. In this upper-middle-class population, men with more educated wives tended to be older, had a lower socioeconomic status, and higher blood pressure levels. A significant increase in risk of all-cause and ischemic heart disease death was seen in men whose wives were more educated than they, compared with men whose wives were less educated. This risk was highest for the least educated men with the most educated wives, and was not totally explained by differences in age, socioeconomic status, blood pressure, or other risk factors. These data support a causal role for status incongruity and fatal ischemic heart disease.