Hippisley-Cox J, Pringle M
Department of General Practice, Medical School, Queen's Medical Centre, Nottingham.
Br J Gen Pract. 1998 Sep;48(434):1580-3.
Studies of couples, who tend to share an environment but are genetically dissimilar, can shed light on the contribution of environmental factors to hypertension. There has been renewed interest in these environmental factors following the re-analysis of the INTERSALT study.
To determine whether patients whose spouses have hypertension are at increased risk of hypertension, using a population-based case-control study.
The total study population consisted of all 3923 patients over 30 years old registered with one general practice. Male cases with hypertension were matched to male controls without hypertension. Female cases with hypertension were matched to female controls without hypertension. The variables were: diagnosed hypertension; having a spouse with diagnosed hypertension; age; sex; weight; height; body-mass index; couple status; diabetes; and systolic and diastolic blood pressure readings.
On multivariate analysis, when age, body-mass index, diabetes, couple status, and having a blood pressure reading were included, men whose spouses had hypertension had a two-fold increased risk of hypertension (adjusted odds ratio (OR) 2.24; 95% CI 1.77-2.72; P = 0.001). Similarly, on multivariate analysis, women whose spouses had hypertension had a two-fold increased risk of hypertension (adjusted OR = 2.23; 95% CI 1.75-2.72; P = 0.001). The risk for both male and female subjects persisted after adjustment for other variables. There was a significant correlation between systolic (r = 0.41; P < 0.0001) and diastolic (r = 0.25; P < 0.0001) blood pressures between spouse pairs.
The independent association between having a spouse with hypertension and increased risk of hypertension supports the view that there are significant environmental factors in the aetiology of hypertension. The finding has implications for the screening and treatment of hypertension in primary care.
对夫妻进行的研究能够揭示环境因素对高血压的影响，夫妻往往共享相同环境，但基因不同。对INTERSALT研究的重新分析引发了对这些环境因素的新关注。
通过一项基于人群的病例对照研究，确定配偶患有高血压的患者患高血压的风险是否增加。
研究总人群包括在一家全科诊所登记的所有3923名30岁以上的患者。患有高血压的男性病例与未患高血压的男性对照进行匹配。患有高血压的女性病例与未患高血压的女性对照进行匹配。变量包括：确诊高血压；配偶患有确诊高血压；年龄；性别；体重；身高；体重指数；夫妻状况；糖尿病；以及收缩压和舒张压读数。
多变量分析时，纳入年龄、体重指数、糖尿病、夫妻状况和有血压读数等因素后，配偶患有高血压的男性患高血压的风险增加了两倍（调整后的优势比（OR）为2.24；95%置信区间为1.77 - 2.72；P = 0.001）。同样，多变量分析时，配偶患有高血压的女性患高血压的风险增加了两倍（调整后的OR = 2.23；95%置信区间为1.75 - 2.72；P = 0.001）。在对其他变量进行调整后，男性和女性受试者的风险仍然存在。配偶之间的收缩压（r = 0.41；P < 0.0001）和舒张压（r = 0.25；P < 0.0001）之间存在显著相关性。
配偶患有高血压与患高血压风险增加之间的独立关联支持了这样一种观点，即高血压病因中存在重要的环境因素。这一发现对初级保健中高血压的筛查和治疗具有启示意义。
