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American Journal of Epidemiology Advance Access originally published online on October 8, 2008
American Journal of Epidemiology 2009 169(1):1-8; doi:10.1093/aje/kwn234
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American Journal of Epidemiology © The Author 2008. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Spousal Concordance for Major Coronary Risk Factors: A Systematic Review and Meta-Analysis

Augusto Di Castelnuovo *, Gianni Quacquaruccio *, Maria Benedetta Donati, Giovanni de Gaetano and Licia Iacoviello

Correspondence to Dr. Licia Iacoviello, Laboratory of Genetic and Environmental Epidemiology, Research Laboratories, Centre for High Technology Research and Education in Biomedical Sciences, Catholic University, Largo Gemelli 1, 86100 Campobasso, Italy (e-mail: licia.iacoviello{at}rm.unicatt.it).

Received for publication January 22, 2008. Accepted for publication July 14, 2008.

Spousal pairs permit assessment of determinants of diseases related to environment, because they share the same lifestyle and environment. The authors reviewed spouses' concordance for the major coronary risk factors. A search of the MEDLINE, PubMed, and EMBASE databases was performed. Seventy-one papers were selected for a total of 207 cohorts of pairs and 424,613 correlations in more than 100,000 couples. The most strongly correlated within-pairs factors were smoking and body mass index, with overall correlations of 0.23 (95% confidence interval: 0.12, 0.36) and 0.15 (95% confidence interval: 0.05, 0.25), respectively. Statistically significant positive correlations were also found for diastolic blood pressure, triglycerides, total and low density lipoprotein cholesterol, weight, and the waist/hip ratio. The overall odds ratios for concordance in hypertension, smoking, diabetes, and obesity were all statistically significant, ranging from 1.16 to 3.25. Assortative mating influenced concordance for blood pressure, smoking, glucose, low density lipoprotein cholesterol, weight, body mass index, and waist circumference. This systematic review shows a statistically significant positive spousal concordance for the majority of main coronary risk factors. However, the strength of the concordance was markedly different among factors and appeared to be quite modest for all of them. Interventions to reduce cardiovascular risk factors should be addressed jointly to both members of a marital couple.

concordance; coronary disease; environment and public health; meta-analysis; risk factors; spouses

Abbreviations: CI, confidence interval; HDL, high density lipoprotein; LDL, low density lipoprotein

* Both Drs. Quacquaruccio and DiCastelnuovo shared equally in their contribution to this work.


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