Discordance in gender role attitudes between spouses and its relationship with the risk biomarkers of cardiovascular diseases: a couple-level analysis

Cardiovascular disease (CVD) is prevalent among older adults, but studies often focus on individual spouses rather than couple dynamics. This study examines how interplay between spouses—specifically discordance in gender role attitudes—relates to CVD risk biomarkers, using couple-matched data from the Korean Social Life, Health, and Aging Project (KSHAP) on 308 older married couples (616 individuals). Actor-partner interdependence models (APIM) reveal that discordant gender role attitudes are significantly associated with higher CVD risk markers—higher systolic blood pressure, higher triglycerides (TG), lower high-density lipoprotein cholesterol (HDL-C), and a higher TG:HDL-C ratio—among wives only. These associations persist after adjusting for individual-level risk factors, including marital quality, sociodemographics, health behaviors, and depressive symptoms. However, no significant association is found with high-sensitivity C-reactive protein. Two groups of wives are identified as being at the greatest risk for CVD: traditional wives with egalitarian husbands and egalitarian wives with traditional husbands.