- Compared to married heart disease patients, being unmarried was associated with a higher risk of dying.
- This is the first study to show an association between marital status and death from any cause and heart disease-related death in a high-risk heart patient population.
DALLAS, Dec. 20, 2017 — Compared to married heart disease patients, being unmarried was associated with a higher risk of dying, according to new research in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.
Scientists have known that divorced individuals are at increased risk for death in general. However, few studies have evaluated the relationship between adverse cardiovascular outcomes and marital status in patients with known or suspected coronary artery disease.
The study of 6,051 patients (average age 63, 23 percent black) undergoing cardiac catheterization for coronary artery disease, is the first to show poor outcomes specifically among those who were divorced, separated, widowed or never married.
Patients were followed for 3.7 years. Researchers found that compared to married patients, being unmarried was associated with:
- 24 percent higher risk of death from any cause;
- 45 percent higher risk of death from cardiovascular disease; and
- 52 percent higher risk of cardiovascular death/heart attack.
And specifically, the risk of cardiovascular death/heart attack was:
- 40 percent higher for those who were never married;
- 41 percent higher for those who were divorced or separated; and
- 71 percent higher for those who had been widowed.
1,085 deaths were reported in this study (including 688 cardiovascular deaths and 272 heart attacks) during the follow-up.
“I was somewhat surprised by the magnitude of the influence of being married has (on heart patients),” said Arshed Quyyumi, M.D., lead researcher and co-director of Emory Clinical Cardiovascular Research Institute and professor of medicine at Emory University in Atlanta. “Social support provided by marriage, and perhaps many other benefits of companionship, are important for people with heart disease.”
Researchers suggest that it may be important to consider marital status in treating coronary artery disease patients. Psychological conditions associated with being unmarried and potentially more aggressive follow-up and therapy needs to be considered in future studies.
Patients with severe heart valve damage, anemia, congenital heart disease, cancer or active inflammatory disease were excluded from this study. Marital status was determined from self-administered questionnaires. Divorced and separated people were combined into one group for this study. Telephone interviews and medical chart abstractions were used to identify adverse outcomes.
Researchers suggest the study be interpreted with caution as it is a retrospective analysis conducted at a single institution and did not follow-up regarding continued marital status. The findings cannot be applied to the general population without cardiovascular disease. In addition, the study did not consider cohabitation.
Co-authors are William M. Schultz, M.D.; Salim S. Hayek, M.D.; Ayman Samman Tahhan, M.D.; Yi-An Ko, Ph.D.; Pratik Sandesara, M.D.; Mosaab Awad, M.D.; Kareem H. Mohammed, M.D.; Keyur Patel M.D.; Michael Yuan, MPH; Shuai Zheng, Ph.D.; Matthew L. Topel, M.D.; Joy Hartsfield; Ravila MBhimani; Tina Varghese, M.D.; Jonathan H. Kim, M.D.; Leslee Shaw, Ph.D.; Peter Wilson, M.D. and Viola Vaccarino M.D., Ph.D. Author disclosures are on the manuscript.
National Institutes of Health grants and the Abraham J. & Phyllis Katz Foundation (Atlanta, GA) helped fund the study.
- Available multimedia is on the right column of the release link - https://newsroom.heart.org/news/unmarried-heart-patients-face-higher-risk-of-death?preview=4b254bc77d6d8651370c421802e28c76
- After Dec. 20, view the manuscript online.
- Marital history linked to stroke survival
- Follow AHA/ASA news on Twitter @HeartNews
- For updates and new science from JAHA, follow @JAHA_AHA
Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at www.heart.org/corporatefunding.
About the American Heart Association
The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.