Breaking News
January 18, 2019 - New study shows link between secondhand smoke and cardiac arrhythmia
January 18, 2019 - DZIF scientists reveal problems with available diagnostics for Zika and chikungunya virus
January 18, 2019 - Breast cancers more likely to metastasize in young women within 10 years of giving birth
January 18, 2019 - Blood vessels can now be created perfectly in a petri dish
January 18, 2019 - Study identifies prominent socioeconomic and racial disparities in health behavior in Indiana
January 18, 2019 - Young-Onset Type 2 Diabetes Tied to Increased Hospitalization Risk
January 18, 2019 - For-profit nursing schools associated with lower performance on nurse licensure test
January 18, 2019 - Considering the culture of consent in medicine
January 18, 2019 - Researchers identify comprehensive guidelines for managing severe atopic dermatitis
January 18, 2019 - Analyzing proteins in blister fluid may classify burn severity more accurately
January 18, 2019 - Study finds higher suicide rates among youth who were Medicaid enrollees
January 18, 2019 - Opioid drugs often overprescribed to children for pain relief, say CHOP surgeons
January 18, 2019 - New biodegradable wound dressing material accelerates healing
January 18, 2019 - Life in Space May Take Toll on Spinal Muscles
January 18, 2019 - Bulldogs’ screw tails linked to human genetic disease
January 18, 2019 - Immunotherapy target identified for pediatric cancers
January 18, 2019 - Financial stress may increase heart disease risk in African Americans
January 18, 2019 - Scientists solve another piece of Ebola virus puzzle
January 18, 2019 - New project finds how endocrine disruptors interfere with thyroid functions
January 18, 2019 - Research finds decline in ketone body utilization when coronary circulation is reduced
January 18, 2019 - Let’s map our DNA and save billions each year in health costs
January 18, 2019 - AI demonstrates potential to identify irregular heart rhythms as well as humans
January 17, 2019 - Study shows link between air pollution and increased risk of sleep apnea
January 17, 2019 - Neck-strengthening exercises can protect athletes from concussions
January 17, 2019 - Computer model shows how to better control MRSA outbreaks
January 17, 2019 - Pain is unpleasant, and now scientists have identified the set of responsible neurons
January 17, 2019 - CUIMC Celebrates 2018-2019
January 17, 2019 - Study reveals potential pathway for endothelial cells to avoid apoptosis
January 17, 2019 - Hamilton Storage launches LabElite DeCapper SL to expand LabElite product family
January 17, 2019 - Location of epigenetic changes co-locate with genetic signal causing psychartric disorder
January 17, 2019 - Researchers awarded 6.1 million euros to address female fertility problems
January 17, 2019 - Counseling appointments fail to reduce weight gain during pregnancy, shows study
January 17, 2019 - Contraceptive patch that could provide 6 months of contraception within seconds
January 17, 2019 - Yeast model may pave way for development of novel therapies for metabolic disorders
January 17, 2019 - Study determines impact of antibiotic perturbation of the gut microbiome on skeletal health
January 17, 2019 - Cardiometabolic Risk Up With Tourette, Chronic Tic Disorder
January 17, 2019 - Hong Kong scientists claim ‘broad-spectrum’ antiviral breakthrough
January 17, 2019 - Researchers discover the brain cells that make pain unpleasant | News Center
January 17, 2019 - Hepatitis Is Common in New Cancer Patients
January 17, 2019 - Podcast: KHN’s ‘What The Health?’ Drug Prices Are Rising Again. Is Someone Going To Do Something About It?
January 17, 2019 - Smoking significantly increases your biological age, study shows
January 17, 2019 - B-group vitamins may be beneficial for people with first episode psychosis
January 17, 2019 - Researchers demonstrate how manganese produces parkinsonian syndrome
January 17, 2019 - Researchers suggest link between personality type and attitude towards others’ bodies
January 17, 2019 - Mutant mice administered with cocaine failed to exhibit hyperactivity, shows study
January 17, 2019 - Health Tip: Understanding a Heart Murmur
January 17, 2019 - Gut protein mutations shield against spikes in glucose
January 17, 2019 - Engineered immune cells target broad range of pediatric solid tumors in mice | News Center
January 17, 2019 - Study provides comprehensive description of associations between mental disorders
January 17, 2019 - Study finds link between high pesticide exposure and poor sense of smell among farmers
January 17, 2019 - Many cancer patients have undiagnosed hepatitis
January 17, 2019 - New study finds only 13% of outpatient antibiotic prescriptions to be appropriate
January 17, 2019 - Stem cell-based approach to diabetes offers hope for treatment
January 17, 2019 - New project receives €8.65 million from EU and Canada to ease genomic, health data sharing
January 17, 2019 - Improvements in pharmacological study to fight cognitive impairment in schizophrenia
January 17, 2019 - Study looks at trends over time in oral antibiotic prescribing by dermatologists
January 17, 2019 - Most substance use disorder treatment facilities do not offer medication treatment
January 17, 2019 - Multiple sclerosis could benefit from stem cell therapy
January 17, 2019 - Researchers manipulate T cells to improve transplant success
January 17, 2019 - Put away your rulers and reach for your phone
January 17, 2019 - Mindfulness linked with fewer menopausal symptoms
January 17, 2019 - Integrated care to women with PMADs offered at several levels
January 17, 2019 - Researchers identify MANF as a rejuvenating factor in parabiosis
January 17, 2019 - Truncal mutations study suggests new direction in origins of cancer
January 17, 2019 - Beckman Coulter launches new ClearLLab 10C System for clinical flow cytometry lab
January 17, 2019 - Effects of linoleic acid on the body are largely dependent on genes, shows study
January 17, 2019 - Pre-injury exercise reduces damage to both muscles and nerves, study finds
January 17, 2019 - Minimizing Antibody Size to Maximize Research Potential
January 17, 2019 - Research finds large genome in tiny forest defoliator
January 17, 2019 - Technology helps reduce the yearning for unhealthy food
January 17, 2019 - Imec develops prototype cardiovascular device
January 17, 2019 - New Drug Application for Insomnia Disorder Treatment Lemborexant Submitted in the United States
January 17, 2019 - What you should know about teeth whitening
January 17, 2019 - Why Older Adults Should Eat More Protein (And Not Overdo Protein Shakes)
January 17, 2019 - Colorectal cancer mortality rates predicted to increase globally
January 17, 2019 - Scientists discover mutational signatures of tumor hypoxia
January 17, 2019 - New evidence shows how fever alters immune cells
January 17, 2019 - Researchers find new class of blood pressure-regulating peptides in vampire bat venom
January 17, 2019 - Promega to exhibit new Maxwell RSC48 platform at 2019 Festival of Genomics
January 17, 2019 - Study pinpoints immune cells that could be key to tackling hypertension
Marital Status Tied to Outcomes in CVD Patients

Marital Status Tied to Outcomes in CVD Patients

image_pdfDownload PDFimage_print

Action Points

  • Heart disease patients who are unmarried may have a higher risk of mortality than their married counterparts.
  • Similar increases in cardiovascular death or MI were found for patients who were divorced or separated, widowed, or never married compared with married patients.

Heart disease patients who are unmarried may have a higher risk of mortality than their married counterparts, according to a study of more than 6,000 patients undergoing cardiac catheterization for coronary artery disease (CAD).

Compared with patients who were married, those who were unmarried had a higher risk of all-cause mortality (hazard ratio 1.24, 95% CI 1.06 to 1.47, cardiovascular death (HR 1.45, 95% CI 1.18 to 1.78), and cardiovascular death or myocardial infarction (HR 1.52, 95% CI 1.27 to 1.83), reported Arshed Quyyumi, MD, of Emory University in Atlanta, and colleagues.

Similar increases in cardiovascular death or MI were found for patients who were divorced or separated (HR 1.41, 95% CI 1.10 to 1.81), widowed (HR 1.71, 95% CI 1.32 to 2.20), or never married (HR 1.40, 95% CI 0.97 to 2.03) compared with married patients, they wrote online in the Journal of the American Heart Association.

The results remained significant even after adjustment for medication prescriptions and socioeconomic risk factors, the authors noted.

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

Quyyumi’s group studied 6,051 patients from the Emory Cardiovascular Biobank, a prospective cohort of patients who underwent cardiac catheterization for suspected or known CAD at Emory Healthcare hospitals from 2003 to 2015. Exclusion criteria included severe valvular heart disease, congenital heart disease, severe anemia, recent blood transfusion, myocarditis, active inflammatory diseases, and active cancer.

Marital status was derived from a self-administered questionnaire at baseline, consisting of married (n=4,088) versus unmarried (n=1,963), never married (n=451), divorced or separated (n=842), or widowed (n=670). Of the overall cohort, 4,256 patients (70.3%) had obstructive CAD and 490 (8%) presented with acute MI, the researchers reported.

Follow-up data was collected via phone interview, electronic health record review, Social Security death index, and state records.

Quyyumi ‘s group reported 1,085 (18%) deaths from all causes, 688 (11%) cardiovascular-related deaths, and 272 (4.5%) incident MI events over a median follow-up period of 3.7 years.

They found a significant interaction between age and all-cause mortality in the unmarried cohort, but not with cardiovascular death or cardiovascular death/MI.

Younger (ages <65 years) unmarried individuals were at higher risk for all-cause mortality (HR: 1.43; 95% CI, 1.09 to 1.89) than those aged ≥65 years, although the rates of cardiovascular death or cardiovascular death/MI were higher in unmarried individuals regardless of age.

After adjustment, widowed patients had a significant increased risk of cardiovascular death (subdistribution hazard ratio: 1.62; 95% CI, 1.23 to 2.13), and cardiovascular death/MI (sHR: 1.71; 95% CI, 1.32 to 2.20) compared with married patients.

Compared with married patients , unmarried patients were more likely to be female and black, less likely to be smokers, and more likely to have hypertension, heart failure, reduced eGFR, or elevated LDL or HDL levels.

Both divorced or separated patients and widowed patients were also more likely to female and black. However, divorced or separated patients tended to be younger with LDL and HDL cholesterol levels, while widowed patients were older with reduced eGFR and a history of hypertension, diabetes mellitus, obstructive CAD, heart failure, presentation with acute MI, or higher HDL level.

The authors concluded that further investigation is needed to determine whether more aggressive treatment strategies can influence outcomes for unmarried patients. “Accounting for unmarried status in the management of patients with CAD, consideration of associated psychological conditions, and potentially more aggressive follow-up and therapy need to be considered in future studies,” they wrote.

The researchers listed the large sample size, diverse multiethnic population, representation of sex and race, and long-term follow-up as study strengths. Limitations included the retrospective analysis, single-center study, and lack of follow-up regarding continued marital status.

Quyyumi and co-authors disclosed no relevant relationships with industry.

  • Reviewed by
    Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

1969-12-31T19:00:00-0500

last updated

Tagged with:

About author

Related Articles