Breaking News
May 27, 2018 - Exercise alters brain’s dopamine system to help treat addiction, study finds
May 27, 2018 - Sepsis patients treated and released from ED for outpatient follow-up experience good outcomes
May 27, 2018 - Initiative cuts overuse of tests, treatments for bronchiolitis
May 27, 2018 - Study links ‘sleep spindles’ to memory reactivation
May 27, 2018 - Scientists develop new method to speed up genome evolution of baker’s yeast
May 27, 2018 - Sunscreen pills are fake says FDA
May 27, 2018 - Study finds increasing wealth gap between households of seniors and families with children
May 27, 2018 - Link between tuberculosis and Parkinson’s disease discovered
May 27, 2018 - Doctors call on health authorities for permission to provide stroke patients with life-saving treatment
May 26, 2018 - Couples who eat seafood-rich diet tend to get pregnant faster
May 26, 2018 - NIH summit presents recommendations to accelerate treatment development for Alzheimer’s disease
May 26, 2018 - Medication-related harm found to be common among older adults, but preventable
May 26, 2018 - Lunaphore and Vitro announce partnership to develop ISH protocols for RNA, DNA targets
May 26, 2018 - Cryoablation Efficacious for Cancer Pain, Review Finds
May 26, 2018 - Link between IBD and Parkinson’s might allow doctors to slow down condition
May 26, 2018 - Study finds fewer than 5% of low-income, urban mothers use prenatal vitamins before pregnancy
May 26, 2018 - California hospitals urge moms to favor breast milk over formula
May 26, 2018 - Most concussion patients do not receive follow-up care after hospital discharge, says study
May 26, 2018 - Lifetime risks of developing Alzheimer’s dementia vary by age, gender
May 26, 2018 - Researchers find novel ways to improve participation in clinical research
May 26, 2018 - Researchers develop methods for measuring free-base nicotine levels in e-cigarettes
May 26, 2018 - AHA: Preterm Birth Could Warn of Mom’s Future Heart Risks
May 26, 2018 - Some calories more harmful than others
May 26, 2018 - Study links cell size with commitment to division
May 26, 2018 - Researchers develop new, rapid blood test to detect liver damage
May 26, 2018 - Researchers discover cascade of immune processes linked to poor outcomes in aggressive breast cancer
May 26, 2018 - New research will use mathematics to solve mysteries in cell biology
May 26, 2018 - Mice remain slim on burger diet
May 26, 2018 - BMC receives $13.5 million award to test methods for delivering childhood anxiety treatment
May 26, 2018 - ‘Right to Try Act’ will not benefit terminally-ill patients
May 26, 2018 - Study reveals novel statistical algorithm to identify potential disease genes
May 26, 2018 - Two genes play vital roles in malignant brain cancer
May 26, 2018 - Study explores link between groundwater lithium and diagnoses of bipolar disorder, dementia
May 26, 2018 - Researchers reveal stimulatory effects of myelin on young neural cells
May 26, 2018 - Small part of cellular protein that helps form long-term memories also drives neurodegeneration
May 26, 2018 - Four-legged friends can have heart issues, too
May 26, 2018 - Scientists create small, self-contained spaces inside mammalian cells
May 26, 2018 - Better Social Support Network Protects Black Men Against HIV
May 26, 2018 - National Heart, Lung, and Blood Institute (NHLBI)
May 26, 2018 - Burnout, depression can affect ophthalmology residents, study finds
May 26, 2018 - Latinos and African Americans more likely to experience serious depression than Whites
May 26, 2018 - Data from past epidemic could help improve response to future Ebola outbreaks
May 26, 2018 - Researchers provide insight into how the memory molecule limits brain plasticity
May 26, 2018 - OSU biologist describes ‘restoration ecology’ approach toward patient health
May 26, 2018 - New approach to study brown fat could aid in finding treatments for obesity
May 26, 2018 - UCI Center on Stress & Health receives NIH funding to develop digital health interventions
May 26, 2018 - Could More Fish in the Diet Boost Sex Lives and Fertility?
May 26, 2018 - NTU Singapore and SERI invent new scope to diagnose glaucoma
May 26, 2018 - Cancer cells co-opt pain-sensing ‘neural channel’ to increase tolerance against oxidative stress
May 26, 2018 - Study uncovers why pesticide exposure increases Parkinson’s disease risk in some people
May 26, 2018 - Study finds link between lead exposure and fertility rates
May 26, 2018 - Causes and treatment of acute heart failure vary by region, registry shows
May 26, 2018 - Delivery of standardized diabetes care could help achieve equitable health outcomes for all patients
May 26, 2018 - FDA authorizes marketing of OsteoDetect software for detecting wrist fractures
May 26, 2018 - HSE experts suggest new way of looking at infantilism
May 26, 2018 - Children and adolescents growing up in extreme societal conditions more likely to resort to violence
May 26, 2018 - New study puts forth most comprehensive tree of life for malaria parasites
May 26, 2018 - UVA researchers establish new guidelines for explorers of the submicroscopic world inside us
May 26, 2018 - Princeton Instruments and C-SOPS announce collaboration on innovative pharmaceutical technology
May 26, 2018 - New research shows why babies need to move in the womb
May 26, 2018 - UK steps forward to tackle global antimicrobial resistance
May 26, 2018 - CRISPR-Cas9-based strategy allows researchers to precisely alter hundreds of different genes
May 26, 2018 - Novoheart announces next generation of ‘Human heart-in-a-jar’ technology for advanced drug discovery
May 26, 2018 - UT Southwestern-led researchers find new way to determine prognosis of invasive kidney cancer
May 26, 2018 - Researchers develop film to prevent bacteria from growing on dental retainers and aligners
May 26, 2018 - Mobile health intervention for people with serious mental illness as effective as clinic-based treatment
May 26, 2018 - Vaginal estradiol tablets outperform moisturizers when treating vulvovaginal problems
May 26, 2018 - Researchers call for new genetic tests for congenital diseases
May 26, 2018 - KHN’s ‘What the Health?’ Campaign promises kept, plus ‘nerd reports’
May 26, 2018 - AARDA collaborates with Allegheny Health Network and new AHN Autoimmunity Institute
May 26, 2018 - Lung-on-a-chip technology could streamline drug-testing for pulmonary fibrosis
May 26, 2018 - Researchers work together to solve mystery of motor neuron death in ALS patients
May 26, 2018 - Study finds early antibiotic initiation for majority of premature infants
May 26, 2018 - New environmental monitoring project finds increased numbers of deer ticks in Southern Indiana
May 26, 2018 - Pediatricians Should Advocate for Life Support Training
May 26, 2018 - Cannabidiol significantly reduces seizures in patients with severe form of epilepsy
May 26, 2018 - Allergies can have serious, far-reaching consequences on adolescents
May 26, 2018 - Scientists develop lab-based system to study mechanisms of common liver disease
May 25, 2018 - New guidelines may help pathologists to more accurately classify and diagnose invasive melanoma
May 25, 2018 - Immune cells promote lung cancer metastases by forming clots in tumors, study finds
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