To examine the association between spouse/partner educational attainment (SPE) and stroke prevalence.

ºÃÉ«ÏÈÉúal attainment demonstrates a well-established inverse relationship with stroke risk. Evidence suggests that SPE may independently influence stroke risk. SPE serves as a proxy for household-level resources, yet its independent contribution to stroke risk remains inadequately characterized.

A cross-sectional analysis of 2024 National Health Interview Survey data was performed including participants ≥ 40 years living with a spouse/partner. The primary exposure variable was SPE. The outcome was self-reported stroke history. Covariates included participants’ own educational attainment, age, sex, race, geographic region, and cardiovascular risk factors. Descriptive statistics, bivariate analyses using Pearson’s chi-squared test and Wilcoxon rank sum test, and correlation analyses were conducted using R.

Overall stroke prevalence was 3.8% with significant sex differences (males 4.7%, females 2.9%, p<0.001). Unadjusted analysis revealed significant associations between lower SPE and stroke (Grade 0-11: OR 1.86, 95% CI 1.14-2.93, p=0.010; High School/GED: OR 1.65, 95% CI 1.22-2.26, p=0.001). After adjusting for individual education, associations were attenuated and non-significant. In fully adjusted multivariate analysis, SPE demonstrated no independent association with stroke across all educational levels (Grade 0-11: OR 0.67, 95% CI 0.37-1.21; High School/GED: OR 0.86, 95% CI 0.59-1.26; Some College: OR 0.75, 95% CI 0.49-1.16; Associate’s Degree: OR 0.93, 95% CI 0.63-1.38; Bachelor’s Degree: OR 0.90, 95% CI 0.64-1.29). Independent predictors in multivariate models were coronary heart disease (OR 2.33, 95% CI 1.80-3.00, p<0.001), hypertension (OR 1.78, 95% CI 1.39-2.28, p<0.001), diabetes (OR 1.48, 95% CI 1.16-1.89, p=0.002), and age (OR 1.04 per year, p<0.001). Sex-stratified multivariate analyses revealed consistent patterns.

SPE demonstrates no independent association with stroke in multivariate analysis after controlling for individual education and cardiovascular risk factors. Crude associations are mediated through traditional risk factors and individual educational attainment.