Association of psychological stress with wives’hypertension across over 10 million Chinese married female population aged 20-49 years

Background:Psychological stress has been reported to be a potential risk factor for hypertension among females,but it remains unclear whether spousal chronic stress levels alter the risk of hypertension among women.We examined the associations between stress within the family and hypertension among married women.Methods:Reproductive-aged women who were planning for pregnancy and their husbands were recruited from the National Free Pre-pregnancy Checkup Projects(NFPCP)across 31 provinces in China in 2016 and 2017.Perceived stress of wives or husbands was measured with a 5-point Likert-type scale,and assessed from three domains:work/life-related stress,economic stress,and overall stress.Multivariable-adjusted logistic regression models were used to assess the associations between stress status and the prevalence of hypertension.Results:Of 10,027,644 couples,261,098(2.60%)women had hypertension.The results showed that higher stress levels among themselves or their husbands were associated with a higher prevalence of hypertension in women(P_(for trend)<0.001).Compared with non-stressed participants,female participants with the highest stress themselves were at a greater risk of hypertension,with adjusted odds ratio(OR)of 1.31(95%confidence interval[CI]:1.25-1.37);and compared with participants whose husbands had no stress,those whose husbands had the highest stress level were at a higher risk of hypertension with adjusted OR of 1.24(95%CI:1.20-1.29).Moreover,compared with non-stressed status for both couples,only-wife-stressed,only-husband-stressed,and both-stressed couples were found to be significantly associated with increased risks of wives’hypertension,with adjusted ORs of 1.28(95%CI:1.25-1.31),1.19(95%CI:1.17-1.21),and 1.28(95%CI:1.26-1.31),respectively.Conclusion:Moderate to severe stress in both spouses might be associated with female hypertension prevalence,which highlights the importance of paying attention to the psychological stresses of couples within the family.

The associations between resilience and socio-demographic factors in parents who care for their children with congenital heart disease

Objective To examine the resilience of parents of children with congenital heart disease and to investigate socio-demographic factors that may influence parents’resilience.Methods This is a web-based survey study using a cross-sectional design.A purposive sampling method was utilized to recruit 515 parents who care for children with congenital heart disease.Resilience was assessed using the Dispositional Resilience Scale-Ⅱ.Based on expert-interviews,a questionnaire was designed to collect socio-demographic data.Descriptive statistics,factor analysis,and linear regressions were used to analyze data.Results A total of 413 parents completed the survey study.The mean resilience score was 3.75(SD=0.61;range=1.89–4.89)with higher scores indicating higher resilience.The linear regression models demonstrated that parents who had lower education levels and lower gross household income had lower resilience(P<0.05).Conclusions Parents reported resilience that reflected their ability to cope with stressful events and mitigate stressors associated with having and caring for children with congenital heart disease.Lower education levels and lower gross household income are associated with lower resilience.To increase parents’resilience,nursing practice and nurse-led interventions should target screening and providing support for parents at-risk for lower resilience.As lower education level and financial hardship are factors that are difficult to modify through personal efforts,charitable foundations,federal and state governments should consider programs that would provide financial and health literacy support for parents at-risk for lower resilience.