A National Dyadic Study of Spousal Education and Hypertension Among Older Couples in the United States

Abstract

This study examines the relationship between spousal education and hypertension risk among older couples. Using data from the National Social Life, Health & Aging Project (NSHAP) Round 3 (2015–2016), we analyzed 1,214 couples aged 50 and older. Hypertension was assessed through biological and self-reported measures. Spousal education was categorized by college degree attainment. The Actor-Partner Interdependence Mediation Model (APIMeM) was used to examine the mediating roles of economic resources and health behaviors. Results showed that a wife’s college degree was associated with lower hypertension risk for both spouses, whereas a husband’s college degree showed no significant association. Mediation analysis revealed that health behaviors, but not economic resources, partially explained this relationship. Findings suggest that a wife’s education plays a greater role in a couple’s hypertension risk than a husband’s, emphasizing the need for interventions targeting couples with a lower-educated wife to improve cardiovascular health in older adults.