Spousal age difference and risk of hypertension in women: evidence from India

There has been steady progress in documenting the psychosocial risk factors of hypertension. However, most of the extant evidence is based on population from the developed countries. Using nationally representative data from India, this cross-sectional study explores whether spousal age gap is associated with risk of hypertension in married women aged 20 to 49 years. Based on the age difference with their husbands, women were grouped into four categories: husband was - i) of similar age, ii) 3-5 years older, iii) 6-9 years older, and iv) 10+ years older. Compared to women whose husbands were of similar age, the odds of having hypertension for the other categories were assessed by estimating multivariable logistic regression models. While the hypertension prevalence in our sample was 18.9%, it was 2.2%-points lower among women whose husbands were of similar age, and 3.3%-points higher among women whose husbands were 10+ years older. The adjusted odds of having hypertension for women with 10+ years of spousal age difference were 1.18 (95% CI: 1.13-1.24) times that of their counterparts who were of similar age to their husbands. These results were persistent in both younger (age 20-34) and older (age 35-49) women and robust across age at marriage, years in marriage, and various socioeconomic sub-groups including women's educational attainment, husband's educational level, household wealth, urban/rural residence, and geographic regions. The relationship also persisted after adjusting for husband's hypertension status. Our findings thus highlight spousal age difference as a biopsychosocial factor influencing the risk of hypertension in women.