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Spouse's Cardiovascular Disease As a Risk Factor for Cardiovascular Disease in Middle-Aged Adults: A Matched-Pair
Hiroyuki Ohbe1, Hideo Yasunaga1
1Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Japan.
Insights
A spouse's history of cardiovascular disease increases cardiovascular event risk in men, but not women. This finding highlights potential shared environmental or lifestyle factors influencing heart health within couples.
Area of Science:
- Cardiovascular Medicine
- Public Health
- Epidemiology
Background:
- Limited understanding exists regarding the risk of subsequent cardiovascular events in individuals whose spouse has a history of cardiovascular disease.
- Assessing the association between a spouse's cardiovascular disease history and an individual's risk of cardiovascular events is crucial for public health.
- Investigating shared risk factors within couples can inform targeted prevention strategies.
Purpose of the Study:
- To determine if a spouse's history of cardiovascular disease is associated with an increased risk of subsequent cardiovascular events.
- To evaluate sex-specific differences in the association between a spouse's cardiovascular disease history and personal cardiovascular event risk.
Main Methods:
- A matched-pair cohort study was conducted using data from the Japan Medical Data Center database (April 2008-August 2018).
- Individuals with no cardiovascular disease history whose spouse had a history (exposure group) were matched with individuals with no cardiovascular disease and spouse without history (non-exposure group) based on birth year, sex, and health check-up year.
- Severe cardiovascular events after the first health check-up were compared between the exposure and non-exposure groups.
Main Results:
- The study included 13,759 individuals in the exposure group and 55,027 in the non-exposure group.
- Individuals in the exposure group had a higher incidence of severe cardiovascular events (0.6%) compared to the non-exposure group (0.4%), with a hazard ratio of 1.48 (95% CI, 1.15-1.90).
- Sex-stratified analyses revealed a higher risk for men (HR 1.68) compared to women (HR 1.22).
Conclusions:
- A spouse's history of cardiovascular disease may serve as a risk factor for subsequent cardiovascular events, particularly in men.
- The findings suggest potential shared lifestyle or environmental factors influencing cardiovascular health within couples.
- Further research is warranted to confirm these findings and develop effective primary prevention strategies for at-risk individuals.
Background:
Little is known about the risk of subsequent cardiovascular events in individuals whose spouse has a history of cardiovascular diseases. We assessed whether the spouse's history of cardiovascular disease is associated with a greater risk of cardiovascular events.
Methods:
Using data on married couples from the Japan Medical Data Center database (April 2008-August 2018), we conducted a matched-pair cohort study by matching individuals who had no history of cardiovascular disease and whose spouse had a history of cardiovascular disease at their first health check-up (exposure group) with up to 4 individuals who had no history of cardiovascular disease and whose spouse had no history of cardiovascular disease at their first health check-up (nonexposure group) matched for birth year, sex, and first health check-up year. We compared severe cardiovascular events after the first health check-up between the 2 groups.
Results:
Among 236 527 eligible married couples (473 054 spouses), we identified 13 759 individuals in the exposure group who were matched with 55 027 individuals in the nonexposure group. During the mean 95-month observational period from the first health check-up, the percentage of individuals with severe cardiovascular events was higher in the exposure group than in the nonexposure group (0.6% [82/13 759] versus 0.4% [224/55 027], respectively), with a hazard ratio of 1.48 (95% CI, 1.15-1.90). Analyses stratified by sex showed that the hazard ratios of the exposure to the spouse's history of cardiovascular disease for severe cardiovascular events in women and men were 1.22 (95% CI, 0.82-1.83) and 1.68 (95% CI, 1.22-2.32), respectively.
Conclusions:
This study suggests that a spouse's history of cardiovascular disease can be a risk factor for subsequent cardiovascular events in men but not in women. Further studies are needed to confirm our findings and to explore effective primary prevention strategies for these individuals.
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