BMJ 2002;325:636 ( 21 September )

Primary care

Married couples' risk of same disease: cross sectional study

Julia Hippisley-Cox, senior lecturer in general practice, ^a Carol Coupland, senior lecturer in medical statistics, ^a Mike Pringle, professor of general practice, ^a Nicola Crown, researcher, ^b Vicky Hammersley, research network co-ordinator, Trent focus. ^a

^a Division of General Practice, School of Community Health Sciences, University of Nottingham, Nottingham NG7 2RD, ^b Collingham Medical Centre, Collingham NG23 7LB

Correspondence to: J Hippisley-Cox julia.hippisley-cox{at}nottingham.ac.uk

Objective: To determine whether people whose marital partners have depression, diabetes, hypertension, ischaemic heart disease, stroke, hyperlipidaemia, peptic ulcer disease, or asthma or chronic obstructive pulmonary disease are at increased risk of the same disease.
Design: Cross sectional study.
Setting: 10 practices from the Trent Focus Collaborative Research Practice Network.
Participants: 8386 married couples (16 772 individuals) from a population of 29 014 participants aged 30-74 years.
Outcomes: Risk of disease in participants whose marital partner had that disease compared with those whose partner did not.
Results: After both partners' age, smoking, and obesity and which general practice they attend were adjusted for, participants whose marital partner had asthma, depression, hypertension, hyperlipidaemia, and peptic ulcer disease were at increased risk of having the same disease. The adjusted odds ratios were 1.69 (95% confidence interval 1.43 to 2.98) for asthma, 2.08 (1.71 to 2.54) for depression, 1.32 (1.04 to 1.67) for hypertension, 1.44 (1.19 to 1.75) for hyperlipidaemia, and 2.01 (1.48 to 2.73) for peptic ulcer disease.
Conclusion: Partners of people with specific diseases are at increased risk of the disease themselvesat least 70% increased risk for asthma, depression, and peptic ulcer disease. This implicates shared environmental causes in some diseases in addition to any genetic or distant exposure or shared behaviours with respect to seeking health care.

What is already known on this topic People whose spouses have hypertension are at increased risk of hypertension Little is known about the risks of disease for spouses of patients with diseases other than hypertension What this study adds People whose marital partner had asthma, depression, and peptic ulcer disease were at increased risk of having the same disease Shared environmental factors contribute to the risk of diseases The costs and benefits of screening people for diseases of their spouses needs to be considered

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