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.

心血管疾病（Cardiovascular disease, CVD）在老年人群中高发，但既往研究多聚焦于个体配偶层面，而非伴侣间的互动关系。本研究依托韩国社会生活、健康与老龄化项目（Korean Social Life, Health, and Aging Project, KSHAP）中308对老年已婚夫妇（共616名受试者）的配对夫妇数据，探讨伴侣间的互动——具体为性别角色态度的不一致性——与心血管疾病风险生物标志物的关联。本研究采用行动者-伴侣互依模型（Actor-partner interdependence models, APIM）进行分析，结果显示：仅在妻子群体中，性别角色态度不一致与不良心血管疾病风险标志物水平显著相关，具体表现为更高的收缩压、更高的甘油三酯（triglycerides, TG）、更低的高密度脂蛋白胆固醇（high-density lipoprotein cholesterol, HDL-C）以及更高的TG与HDL-C比值。在调整婚姻质量、社会人口学特征、健康行为及抑郁症状等个体层面风险因素后，上述关联依然显著。不过，该关联与高敏C反应蛋白（high-sensitivity C-reactive protein）并无显著关联。本研究还识别出两类心血管疾病风险最高的妻子群体：传统型妻子搭配平等主义丈夫，以及平等主义妻子搭配传统型丈夫。