The impact of marital status on hypertension: SEM analysis of a Chinese general population cohort

Abstract

Background: Hypertension, a chronic non-communicable disease, has multifaceted and complex etiologies influenced by various risk factors. This study examines the role of marital status among the factors influencing blood pressure levels and assesses its potential indirect effects through other variables. Methods: This study involved 1852 individuals from the Baoding area in the Beijing-Tianjin-Hebei region, China. Participants were categorized by gender and marital status. Descriptive statistical methods and Structural Equation Modeling (SEM) were utilized for comprehensive data analysis in this study. Results: Women in the marital turmoil group (divorced or widowed) had higher mean systolic blood pressure compared to those in the married group. A significant age difference between the two groups (p = 0.024) may introduce bias into the results. Gender-stratified SEM results show that marital status neither directly nor indirectly affects blood pressure in men. In women, marital status indirectly affects blood pressure through two pathways: “Marital Status (standardized path coefficient, β = 0.15, p < 0.001) - Economic Status (β = − 0.33, p < 0.001) - Dietary Habits (β = 0.12, p < 0.05) - Blood Pressure” and “Marital Status (β = 0.15, p < 0.001) - Economic Status (β = − 0.33, p < 0.001) - Dietary Habits (β = 0.02, p < 0.01) - Obesity (β = 0.24, p < 0.001) - Blood Pressure.” Conclusion: Results confirm a close association between marital status and hypertension in women, with factors like age and economic status potentially influencing this relationship. This underscores the need for further research to explore the intricate connections between marriage and blood pressure. The study advocates for medical institutions and communities to offer psychological health support to those undergoing marital difficulties and stresses the significance of health education in addressing hypertension risk factors.