{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T10:18:58Z","timestamp":1784715538650,"version":"3.55.0"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T00:00:00Z","timestamp":1688342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Jiangxi Provincial Health Commission Science and Technology Plan","award":["SKJP220225994"],"award-info":[{"award-number":["SKJP220225994"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Objectives<\/jats:title>\n                  <jats:p>Cross-sectional studies have suggested a potential association between living alone and hypertension risk, but longitudinal evidence remains limited. We aimed to investigate the correlation between living alone, alterations in living arrangements, and hypertension risk among older adults utilizing a population-based longitudinal design.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Research Design and Methods<\/jats:title>\n                  <jats:p>The study included 8\u2009782 older adults (\u226565 years) without hypertension from the Chinese Longitudinal Healthy Longevity Survey. Participants were surveyed during the 2008 and 2011\/2012 waves and were subsequently followed up in the next wave. Hypertension was defined as systolic blood pressure \u2265140 mmHg and\/or diastolic blood pressure \u226590 mmHg, or a self-reported diagnosis of hypertension by a physician. Cox proportional hazards model was used to explore the association between living alone and hypertension. Additionally, we analyzed how switching living arrangements during the follow-up period affects hypertension.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>During a median follow-up of 2.8 (1.7\u20133.0) years, 2\u2009750 hypertension events occurred. Compared with living with family, the hazard ratio (HR) (95% confidence interval [CI]) of living alone was 1.19 (1.06\u20131.33) for hypertension. Similarly, persisting in living alone during follow-up increased the risk of hypertension compared to continuing to live with family (HR 1.24; 95% CI: 1.06\u20131.45). Compared to married participants who continued to live with family, widowed\/divorced participants who transitioned from living with family to living alone experienced a higher risk of hypertension (HR 1.21; 95% CI: 1.00\u20131.47). Stratified analyses showed that living alone was only associated with an increased hypertension risk for participants aged &amp;gt;80, men, and rural residents.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion and Implications<\/jats:title>\n                  <jats:p>Living alone at baseline or persisting in living alone during follow-up correlated with increased hypertension risk. Divorced or widowed individuals who transitioned from living with family to living alone were still at risk. These results indicate that social support and living arrangements may be important in preventing hypertension in older adults.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/geroni\/igad071","type":"journal-article","created":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T18:49:22Z","timestamp":1688410162000},"source":"Crossref","is-referenced-by-count":13,"title":["Living Alone Increases the Risk of Hypertension in Older Chinese Adults: A Population-Based Longitudinal Study"],"prefix":"10.1093","volume":"7","author":[{"given":"Xiang","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Cardiology, Jiujiang No. 1 People\u2019s Hospital , Jiujiang, Jiangxi , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangyang","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Jiujiang No. 1 People\u2019s Hospital , Jiujiang, Jiangxi , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Jiujiang No. 1 People\u2019s Hospital , Jiujiang, Jiangxi , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quan","family":"He","sequence":"additional","affiliation":[{"name":"Medical Records Department, Jiujiang No. 1 People\u2019s Hospital , Jiujiang, Jiangxi , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Jie","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Jiujiang No. 1 People\u2019s Hospital , Jiujiang, Jiangxi , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1739-5531","authenticated-orcid":false,"given":"Miao","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Jiujiang No. 1 People\u2019s Hospital , Jiujiang, Jiangxi , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,7,3]]},"reference":[{"issue":"1","key":"2023091306562736200_CIT0001","doi-asserted-by":"crossref","first-page":"e0190033","DOI":"10.1371\/journal.pone.0190033","article-title":"Association of loneliness with all-cause mortality: a meta-analysis","volume":"13","author":"Rico-Uribe","year":"2018","journal-title":"PLoS One."},{"key":"2023091306562736200_CIT0002","author":"China Scientific Research Center on Aging","year":"2010"},{"key":"2023091306562736200_CIT0003","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1007\/BF03500920","article-title":"China family development report (2015)","volume":"1","author":"Liu","year":"2017","journal-title":"China Popul Dev Stud"},{"issue":"47","key":"2023091306562736200_CIT0004","doi-asserted-by":"crossref","first-page":"71911","DOI":"10.1007\/s11356-022-20892-w","article-title":"Does living alone increase the consumption of social resources","volume":"29","author":"Long","year":"2022","journal-title":"Environ Sci Pollut Res Int."},{"key":"2023091306562736200_CIT0005","first-page":"24","article-title":"Analysis on the living style and influencing factors of the widowed elderly in China-based on data from the fourth sample survey of the living conditions of China\u2019s urban and rural elderly in 2015","volume":"2","author":"Li","year":"2019","journal-title":"Res World"},{"key":"2023091306562736200_CIT0006","doi-asserted-by":"crossref","first-page":"673181","DOI":"10.1155\/2011\/673181","article-title":"Living alone, loneliness, and psychological well-being of older persons in singapore","volume":"2011","author":"Lim","year":"2011","journal-title":"Curr Gerontol Geriatr Res"},{"issue":"21","key":"2023091306562736200_CIT0007","doi-asserted-by":"crossref","first-page":"14572","DOI":"10.3390\/ijerph192114572","article-title":"Exploring the influencing factors on living alone and social isolation among older adults in rural areas of Thailand","volume":"19","author":"Iamtrakul","year":"2022","journal-title":"Int J Environ Res Public Health."},{"key":"2023091306562736200_CIT0008","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.socscimed.2015.03.054","article-title":"Living arrangements as determinants of myocardial infarction incidence and survival: a prospective register study of over 300,000 Finnish men and women","volume":"133","author":"Kilpi","year":"2015","journal-title":"Soc Sci Med"},{"issue":"7","key":"2023091306562736200_CIT0009","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1097\/PSY.0b013e3181ae5770","article-title":"Living alone is associated with an increased risk of type 2 diabetes mellitus in men but not women from the general population: the MONICA\/KORA Augsburg Cohort Study","volume":"71","author":"Meisinger","year":"2009","journal-title":"Psychosom Med."},{"issue":"2","key":"2023091306562736200_CIT0010","first-page":"293","article-title":"Living alone during old age and the risk of dementia: assessing the cumulative risk of living alone","volume":"78","author":"Shaw","year":"2022","journal-title":"J Gerontol Series B Psychol Sci Soc Sci"},{"issue":"15","key":"2023091306562736200_CIT0011","doi-asserted-by":"crossref","first-page":"9246","DOI":"10.3390\/ijerph19159246","article-title":"Association between loneliness and depression among community-dwelling older women living alone in South Korea: the mediating effects of subjective physical health, resilience, and social support","volume":"19","author":"Lim","year":"2022","journal-title":"Int J Environ Res Public Health."},{"key":"2023091306562736200_CIT0012","doi-asserted-by":"crossref","first-page":"101677","DOI":"10.1016\/j.eclinm.2022.101677","article-title":"Living alone and all-cause mortality in community-dwelling adults: a systematic review and meta-analysis","volume":"54","author":"Zhao","year":"2022","journal-title":"EClinicalMedicine"},{"issue":"2","key":"2023091306562736200_CIT0013","first-page":"67","article-title":"2019 Chinese guideline for the management of hypertension in the elderly","volume":"16","author":"Hua","year":"2019","journal-title":"J Geriatr Cardiol"},{"issue":"4","key":"2023091306562736200_CIT0014","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.anr.2015.10.006","article-title":"Association of family composition and metabolic syndrome in Korean adults aged over 45 years old","volume":"9","author":"Kim","year":"2015","journal-title":"Asian Nurs Res"},{"issue":"4","key":"2023091306562736200_CIT0015","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1097\/HJH.0000000000002688","article-title":"Social connections and hypertension in women and men: a population-based cross-sectional study of the Canadian Longitudinal Study on Aging","volume":"39","author":"Hosseini","year":"2021","journal-title":"J Hypertens."},{"issue":"5","key":"2023091306562736200_CIT0016","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1038\/s41440-023-01183-4","article-title":"Trends in blood pressure and hypertension among older adults and oldest-old individuals in China between 2008-2018","volume":"46","author":"Tan","year":"2023","journal-title":"Hypertens Res"},{"issue":"5","key":"2023091306562736200_CIT0017","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1159\/000350531","article-title":"Sociodemographic correlates of four indices of blood pressure and hypertension among older persons in Japan","volume":"59","author":"Davarian","year":"2013","journal-title":"Gerontology."},{"issue":"10079","key":"2023091306562736200_CIT0018","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1016\/S0140-6736(17)30548-2","article-title":"Survival, disabilities in activities of daily living, and physical and cognitive functioning among the oldest-old in China: a cohort study","volume":"389","author":"Zeng","year":"2017","journal-title":"Lancet."},{"key":"2023091306562736200_CIT0019","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1001\/jama.1963.03060120024016","article-title":"Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function","volume":"185","author":"Katz","year":"1963","journal-title":"JAMA."},{"issue":"12","key":"2023091306562736200_CIT0020","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1093\/gerona\/glp130","article-title":"Basic ADL disability and functional limitation rates among older Americans from 2000-2005: the end of the decline","volume":"64","author":"Fuller-Thomson","year":"2009","journal-title":"J Gerontol A Biol Sci Med Sci."},{"issue":"2","key":"2023091306562736200_CIT0021","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1007\/s12603-017-0907-2","article-title":"Association between body mass index and all-cause mortality among oldest old Chinese","volume":"22","author":"Wang","year":"2018","journal-title":"J Nutr Health Aging"},{"issue":"2","key":"2023091306562736200_CIT0022","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.cjca.2015.05.015","article-title":"A review of propensity-score methods and their use in cardiovascular research","volume":"32","author":"Deb","year":"2016","journal-title":"Can J Cardiol."},{"issue":"6","key":"2023091306562736200_CIT0023","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1093\/ejcts\/ezy167","article-title":"Statistical primer: propensity score matching and its alternatives","volume":"53","author":"Benedetto","year":"2018","journal-title":"Eur J Cardiothorac Surg."},{"issue":"11","key":"2023091306562736200_CIT0024","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1157\/13080958","article-title":"Relationship between social network and hypertension in older people in Spain","volume":"58","author":"Redondo-Sendino","year":"2005","journal-title":"Rev Esp Cardiol."},{"key":"2023091306562736200_CIT0025","doi-asserted-by":"crossref","first-page":"e2017034","DOI":"10.4178\/epih.e2017034","article-title":"Effects of living alone versus with others and of housemate type on smoking, drinking, dietary habits, and physical activity among elderly people","volume":"39","author":"Jeong","year":"2017","journal-title":"Epidemiol Health"},{"key":"2023091306562736200_CIT0026","doi-asserted-by":"crossref","first-page":"111268","DOI":"10.1016\/j.nut.2021.111268","article-title":"Dietary habits and medical examination findings in Japanese adults middle-aged or older who live alone","volume":"89","author":"Nakashima","year":"2021","journal-title":"Nutrition"},{"issue":"9","key":"2023091306562736200_CIT0027","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1080\/00981389.2018.1497748","article-title":"A comparison of urban and non-urban African American older adults on health-related characteristics","volume":"57","author":"Oh","year":"2018","journal-title":"Soc Work Health Care."},{"issue":"1","key":"2023091306562736200_CIT0028","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1093\/geronb\/gbn002","article-title":"Living alone and depressive symptoms: the influence of gender, physical disability, and social support among Hispanic and non-Hispanic older adults","volume":"64","author":"Russell","year":"2009","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"key":"2023091306562736200_CIT0029","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1146\/annurev-psych-010814-015240","article-title":"The neuroendocrinology of social isolation","volume":"66","author":"Cacioppo","year":"2015","journal-title":"Annu Rev Psychol."},{"issue":"45","key":"2023091306562736200_CIT0030","doi-asserted-by":"crossref","first-page":"17058","DOI":"10.1073\/pnas.0605053103","article-title":"Day-to-day dynamics of experience\u2014cortisol associations in a population-based sample of older adults","volume":"103","author":"Adam","year":"2006","journal-title":"Proc Natl Acad Sci U S A."},{"issue":"10","key":"2023091306562736200_CIT0031","doi-asserted-by":"crossref","first-page":"2150","DOI":"10.3390\/ijms18102150","article-title":"Hypothalamic-pituitary-adrenal axis modulation of glucocorticoids in the cardiovascular system","volume":"18","author":"Burford","year":"2017","journal-title":"Int J Mol Sci."},{"issue":"23","key":"2023091306562736200_CIT0032","doi-asserted-by":"crossref","first-page":"13357","DOI":"10.1073\/pnas.96.23.13357","article-title":"Down-regulation of the expression of endothelial NO synthase is likely to contribute to glucocorticoid-mediated hypertension","volume":"96","author":"Wallerath","year":"1999","journal-title":"Proc Natl Acad Sci U S A."},{"issue":"12","key":"2023091306562736200_CIT0033","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1089\/ars.2012.4569","article-title":"Neuroendocrine profile in a rat model of psychosocial stress: relation to oxidative stress","volume":"18","author":"Colaianna","year":"2013","journal-title":"Antioxid Redox Signal."},{"issue":"3","key":"2023091306562736200_CIT0034","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1097\/00006842-200205000-00005","article-title":"Loneliness and health: potential mechanisms","volume":"64","author":"Cacioppo","year":"2002","journal-title":"Psychosom Med."},{"issue":"1","key":"2023091306562736200_CIT0035","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1037\/0022-3514.85.1.105","article-title":"Loneliness in everyday life: cardiovascular activity, psychosocial context, and health behaviors","volume":"85","author":"Hawkley","year":"2003","journal-title":"J Pers Soc Psychol."},{"issue":"1","key":"2023091306562736200_CIT0036","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1037\/a0017805","article-title":"Loneliness predicts increased blood pressure: 5-year cross-lagged analyses in middle-aged and older adults","volume":"25","author":"Hawkley","year":"2010","journal-title":"Psychol Aging."},{"key":"2023091306562736200_CIT0037","doi-asserted-by":"crossref","first-page":"104341","DOI":"10.1016\/j.archger.2021.104341","article-title":"Relationship between the living-alone period and depressive symptoms among the elderly","volume":"94","author":"Koo","year":"2021","journal-title":"Arch Gerontol Geriatr."},{"issue":"6","key":"2023091306562736200_CIT0038","doi-asserted-by":"crossref","first-page":"S311","DOI":"10.1093\/geronb\/60.6.S311","article-title":"Social networks among men and women: the effects of age and socioeconomic status","volume":"60","author":"Ajrouch","year":"2005","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"key":"2023091306562736200_CIT0039","doi-asserted-by":"crossref","first-page":"167","DOI":"10.4054\/DemRes.2012.27.7","article-title":"Living arrangements, intergenerational support types and older adults loneliness in Eastern and Western Europe","volume":"27","author":"de Jong Gierveld","year":"2012","journal-title":"Demogr Res"},{"key":"2023091306562736200_CIT0040","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.bbi.2019.08.189","article-title":"Social engagement and loneliness are differentially associated with neuro-immune markers in older age: time-varying associations from the English Longitudinal Study of Ageing","volume":"82","author":"Walker","year":"2019","journal-title":"Brain Behav Immun."},{"key":"2023091306562736200_CIT0041","doi-asserted-by":"crossref","first-page":"105194","DOI":"10.1016\/j.psyneuen.2021.105194","article-title":"Endocrine and immunomodulatory effects of social isolation and loneliness across adulthood","volume":"128","author":"Zilioli","year":"2021","journal-title":"Psychoneuroendocrinology."},{"issue":"9","key":"2023091306562736200_CIT0042","doi-asserted-by":"crossref","first-page":"761","DOI":"10.7326\/0003-4819-139-9-200311040-00011","article-title":"Pathogenesis of hypertension","volume":"139","author":"Oparil","year":"2003","journal-title":"Ann Intern Med."},{"issue":"6","key":"2023091306562736200_CIT0043","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1093\/ageing\/afab155","article-title":"Why is living alone in older age related to increased mortality risk? A longitudinal cohort study","volume":"50","author":"Abell","year":"2021","journal-title":"Age Ageing."},{"issue":"1","key":"2023091306562736200_CIT0044","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1186\/s12889-016-3682-9","article-title":"Marital status, widowhood duration, gender and health outcomes: a cross-sectional study among older adults in India","volume":"16","author":"Perkins","year":"2016","journal-title":"BMC Public Health."},{"issue":"5","key":"2023091306562736200_CIT0045","doi-asserted-by":"crossref","first-page":"e193933","DOI":"10.1001\/jamanetworkopen.2019.3933","article-title":"Association of social and behavioral risk factors with earlier onset of adult hypertension and diabetes","volume":"2","author":"Pantell","year":"2019","journal-title":"JAMA Netw Open."},{"issue":"8","key":"2023091306562736200_CIT0046","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1016\/0277-9536(92)90259-S","article-title":"Gender, marital status and the social control of health behavior","volume":"34","author":"Umberson","year":"1992","journal-title":"Soc Sci Med"},{"key":"2023091306562736200_CIT0047","doi-asserted-by":"crossref","first-page":"101122","DOI":"10.1016\/j.arr.2020.101122","article-title":"Living alone and risk of dementia: a systematic review and meta-analysis","volume":"62","author":"Desai","year":"2020","journal-title":"Ageing Res Rev."}],"container-title":["Innovation in Aging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/innovateage\/advance-article-pdf\/doi\/10.1093\/geroni\/igad071\/50789594\/igad071.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/innovateage\/article-pdf\/7\/6\/igad071\/51537638\/igad071.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/innovateage\/article-pdf\/7\/6\/igad071\/51537638\/igad071.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T06:57:17Z","timestamp":1694588237000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/innovateage\/article\/doi\/10.1093\/geroni\/igad071\/7218335"}},"subtitle":[],"editor":[{"given":"Nancy W","family":"Glynn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,7,3]]},"references-count":47,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,7,25]]}},"URL":"https:\/\/doi.org\/10.1093\/geroni\/igad071","relation":{},"ISSN":["2399-5300"],"issn-type":[{"value":"2399-5300","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,7,25]]},"published":{"date-parts":[[2023,7,3]]},"article-number":"igad071"}}