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Unmarried patients with heart problems at higher risk of death: study

Woman holding heart. Science Photo Library/Getty Images

Being unmarried could put heart patients at a higher risk of dying when compared to their married counterparts, a new study by the American Heart Association says.

It is known that those who are divorced are at an increased risk of death in general. But few studies have looked at the relationship between cardiovascular outcomes and marital status in patients with known or suspected coronary artery disease, researchers say.

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The study looked at 6,051 patients with an average age of 63 who were undergoing cardiac catheterization for coronary artery disease. Patients were followed for 3.7 years.

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Researchers say this is the first study to show poor outcomes specifically among people who were divorced, separated, widowed or never married.

Compared to those who were married, unmarried people were associated with a higher risk of three health outcomes (the study did not consider cohabitation).

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First, unmarried people were at a:

  • 24 per cent higher risk of death from any cause.
  • 45 per cent higher risk of death from cardiovascular disease.
  • 52 per cent higher risk of cardiovascular death or heart attack.

And specifically, the risk of cardiovascular death or heart attack was 40 per cent higher for unmarried individuals; 41 per cent higher for those who are divorced or separated; and 71 per cent higher for those who are widowed.

The number of deaths reported in the study included 688 cardiovascular deaths and 272 heart attacks during the followup.

“I was somewhat surprised by the magnitude of the influence of being married has [on heart patients,” lead researchers Arshed Quyyumi said in a statement. “Social support provided by marriage, and perhaps many other benefits of companionship, are important for people with heart disease.”

According to the researchers, unmarried individuals were more likely to be female, black, have hypertension, heart failure or high cholesterol and less likely to be smokers compared with the married patients.

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Researchers add that it may be important for health-care providers to consider marital status when treating coronary artery disease in their patients. They say psychological conditions associated with being unmarried, as well as more aggressive followup and therapy, need to be considered for future studies.

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Another study conducted by the European Society of Cardiology also looked into how marriage can impact middle-aged women and men when it comes to heart attacks.

Researchers analyzed 15,330 acute cardiac syndromes over 10 years. That’s when they found that unmarried men had about a 58 to 66 per cent higher risk of experiencing an acute cardiac syndrome; unmarried women had a 60 to 65 per cent higher risk.

A similar link was also found with cancer outcomes in another 2013 study by the American Society of Clinical Oncology.

The large study looked at data of 734,889 patients who were diagnosed between 2004 and 2008 with either lung, colorectal, breast, pancreatic, prostate, liver/bile duct, head and neck, ovarian and esophageal cancer, as well as non-Hodgkin lymphoma.

The results showed that patients who were married were 17 per cent less likely to have metastatic disease when first diagnosed with cancer compared to patients who were not married. Married patients with non-metastatic disease were 53 per cent more likely to get therapy for their disease compared to unmarried patients, and patients who were married were 20 per cent more likely to be alive than those were not married.

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“Marriage probably improves outcomes among patients with cancer through increased social support,” lead author Ayal Aizer, said in a statement. “Our results suggest that patients who are not married should reach out to friends, cancer support or faith-based groups, and their doctors to obtain adequate social support.”

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