Spousal concordance for major coronary risk factors: A systematic review and meta-analysis

Augusto Di Castelnuovo, Gianni Quacquaruccio, Maria Benedetta Donati, Giovanni De Gaetano, Licia Iacoviello

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalAmerican Journal of Epidemiology
Issue number1
Publication statusPublished - Jan 2009


  • Concordance
  • Coronary disease
  • Environment and public health
  • Meta-analysis
  • Risk factors
  • Spouses

ASJC Scopus subject areas

  • Epidemiology


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