Objective: Psychosocial factors, such as environmental stressors, can increase the risk of hypertension. This study examines the role of the household environment in hypertension outcomes by assessing the link between female hypertension status and spousal alcohol consumption in Nepal.

Study design: This is a cross-sectional study.

Methods: We used the 2016 Nepal Demographic and Health Survey to assess differences in hypertension outcomes in women aged 15 to 49 years whose husbands drink alcohol and in those whose husbands do not. We estimated a multinomial logistic model to obtain adjusted differences in the likelihood of being hypertensive between the two groups. We also examined several socio-economic conditions across the two groups to discuss various aspects of the association.

Results: After controlling for anthropometric and various sociodemographic attributes, we find that women whose husbands drink alcohol were 2.5 percentage points (95% confidence interval [CI]: -0.31, 5.31) more likely to be hypertensive than women whose husbands do not. They were also more likely to experience food insecurity, to experience spousal violence, and to consume tobacco products. Among women whose husbands became intoxicated ('got drunk') very often, the likelihood of being hypertensive was 4.0 percentage points (95% CI: -0.26, 7.67) higher than among women whose husbands do not drink alcohol.

Conclusion: Women whose husbands consume alcohol have an elevated risk of being hypertensive, illustrating the association between hypertension and the household environment. The findings document the added hypertension burden in socially vulnerable population groups and can inform initiatives to reduce alcohol consumption in Nepal.