Spousal caregiving and incident hypertension.

TitleSpousal caregiving and incident hypertension.
Publication TypeJournal Article
Year of Publication2012
AuthorsCapistrant, BD, J Moon, R, M. Glymour, M
JournalAm J Hypertens
Date Published2012 Apr
ISSN Number1941-7225
KeywordsActivities of Daily Living, Aged, Cardiovascular Diseases, Caregivers, Female, Follow-Up Studies, Humans, Hypertension, Male, Memory Disorders, Middle Aged, Odds Ratio, Spouses, Stress, Psychological

BACKGROUND: Caring for one's spouse has been associated with poor health, including risk of cardiovascular disease (CVD) onset and mortality. However, few studies have assessed the risk of incident hypertension associated with spousal caregiving. This paper investigates this association in a large, nationally representative sample of American older adults.

METHODS: Married, hypertension-free, Health and Retirement Study (HRS) respondents aged 50+ in 2000, (n = 5,708) were followed up to 8 years (1,708 new self-reported hypertension diagnoses). Current caregiving exposure was defined as assisting a spouse with instrumental or basic activities of daily living (IADLs) 14+ h/week; we define providing ≥14 h/week of care at two consecutive biennial surveys as "long-term caregiving." We used inverse probability weighted discrete-time hazard models with time-updated exposure and covariates to estimate effects of current and long-term caregiving on incident hypertension. We tested for effect modification by race, gender, and recipient memory illness. Sensitivity analyses restricted to respondents whose spouses had care needs.

RESULTS: After adjusting for demographic, socioeconomic, and health factors, (including risk behaviors, comorbid conditions, and self-rated health), current caregiving significantly predicted hypertension incidence (risk ratio (RR) = 1.36, 95% confidence interval (CI): 1.01, 1.83). For long-term caregivers, there was significant evidence of risk of hypertension onset associated with caregiving (RR = 2.29, 95% CI: 1.17, 4.49). The risk of hypertension onset associated with both current and long-term caregiving did not vary by race, gender, or recipient memory illness diagnosis. Sensitivity analyses supported the primary findings.

CONCLUSIONS: Providing IADL care to a spouse significantly predicted hypertension onset in a nationally representative sample of US adults.

User Guide Notes


Endnote Keywords

ADL/IADL/caregiving/Spousal death/Spousal death/Hypertension/mortality/Hazard model

Endnote ID


Alternate JournalAm J Hypertens
Citation Key7772
PubMed ID22189941
PubMed Central IDPMC3836043
Grant ListU01 AG009740 / AG / NIA NIH HHS / United States
R21 AG034385 / AG / NIA NIH HHS / United States
R24 HD050924 / HD / NICHD NIH HHS / United States
T32-HL098048-01 / HL / NHLBI NIH HHS / United States
U01AG009740 / AG / NIA NIH HHS / United States
T32 HL098048 / HL / NHLBI NIH HHS / United States