Piroska BALOG*1, Paul FALGER2, Gábor SZABÓ1, Csaba L. DÉGI1 ,
Éva KÁLLAY3, Adrienne STAUDER1 , Andrea SZÉKELY4 , Mária S. KOPP1
1 Semmelweis University of Medicine, Budapest, Hungary
2 Maastricht University, Maastricht, The Netherlands (retired)
3 Babes-Bolyai University, Cluj-Napoca, Romania
4 Gottsegen György National Institute of Cardiology, Budapest, Hungary
Little is known about the associations between marital distress, hypertension and depression, in the light of gender differences. The major objective of the present study was to clarify these associations based on a representative health survey, the Hungarostudy 2002 (N=12,680). In our study, we analysed survey data of men (N=1,104) and women (N=809) younger than age 65, who were married or cohabitating and economically active at the time of examination. Self-reported marital distress (Stockholm Marital Stress Scale) and depressive symptoms (Beck Depression Inventory) were included in the survey. Those subjects, who, during the previous year had been diagnosed by a physician as suffering from hypertension or depression and were treated accordingly, were classified as ‘hypertensive’ or ‘depressed’. Hierarchical logistic regression analyses evaluated the effects of marital distress on hypertensive or depressed subjects, compared to healthy controls. Analyses were adjusted for age, SES, BMI, and lifestyle factors. Odds ratios (OR) with 95% confidence intervals were calculated. Our results have shown that in men, but not in women, marital distress was independently associated with hypertension treatment [OR=1.78 (1.11-2.86); p< .001]. After including depressive symptoms, these replaced marital distress as the only significant association [OR = 2.77 (1.83-4.20); p< .001], thus constituting a modifying factor. In women, but not in men, marital distress was associated with elevated risk of depression treatment [OR = 3.38 (1.83-6.26); p< .001]. In conclusion, in the case of the male participants, marital distress was independently associated with hypertension treatment, simultaneously influenced by depressive symptoms; in women, marital distress was independently associated with being treated for depression only.
Keywords: psychological problems, heart and circulation, depression, gender, multivariate analyses