Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 30;25(1):2981.
doi: 10.1186/s12889-025-24382-9.

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

Yajiao Fan #  1 , Huijing He #  2   3 , Haojun Li  4 , Zhili Chen  2 , Chang Liu  1 , Lei Ma  1 , Zehua Xu  1 , Jiayi Zhao  1 , Yuhan Wu  1 , Zeqi Liu  5 , Guangliang Shan  6   7
Affiliations

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

Yajiao Fan et al. BMC Public Health. .

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.

Keywords: Hypertension; Marital status; Structural Equation Modeling.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The studies involving human participants were reviewed and approved by bio Ethical Committee of Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences(NO.055-2020). The patients/participants provided their written informed consent to participate in this study. All methods and experiments were performed in accordance with the relevant guidelines and regulations. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The conceptual framework
Fig. 2
Fig. 2
The chi-square and Mahalanobis distance plot
Fig. 3
Fig. 3
The scree plot
Fig. 4
Fig. 4
The structural equation model diagram for the male group
Fig. 5
Fig. 5
The structural equation model diagram for the female group
See this image and copyright information in PMC

References

    1. Zhou M, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: a systematic analysis for the global burden of disease study 2017. Lancet. 2019;394:1145–58. - PMC - PubMed
    1. Bromfield S, Muntner P. High blood pressure: the leading global burden of disease risk factor and the need for worldwide prevention programs. Curr Hypertens Rep. 2013;15:134–6. - PMC - PubMed
    1. GBD 2013 Risk Factors Collaborators, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2015;386:2287–323. - PMC - PubMed
    1. Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16:223–37. - PMC - PubMed
    1. Fang L, et al. Prevalence and characteristics of hypertension in mainland Chinese adults over decades: a systematic review. J Hum Hypertens. 2014;28:649–56. - PubMed

Supplementary concepts

Grants and funding

LinkOut - more resources