Marital status and risk of cardiovascular diseases: a systematic review and meta-analysis

Chun Wai Wong, Chun Shing Kwok*, Aditya Narain, Martha Gulati, Anastasia S. Mihalidou, Pensee Wu, Mirvat Alasnag, Phyo Kyaw Myint, Mamas A. Mamas

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    60 Citations (Scopus)

    Abstract

    Background: The influence of marital status on the incidence of cardiovascular disease (CVD) and prognosis after CVD is inconclusive. We systematically reviewed the literature to determine how marital status influences CVD and prognosis after CVD. 

    Methods: A search of MEDLINE and Embase in January 2018 without language restriction was performed to identify studies that evaluated the association between marital status and risk of CVD. Search terms related to both marital status and CVD were used and included studies had to be prospective in design. The outcomes of interest were CVD, coronary heart disease (CHD) or stroke incidence and mortality. We performed random effects meta-analysis stratified by the types of population by calculating odds ratios (OR) and 95% confidence intervals (95% CI). 

    Results: Our analysis included 34 studies with more than two million participants. Compared with married participants, being unmarried (never married, divorced or widowed) was associated with increased odds of CVD (OR 1.42; 95% CI 1.00 to 2.01), CHD (OR 1.16,95% CI 1.04 to 1.28), CHD death (OR 1.43,95% CI 1.28 to 1.60) and stroke death (OR 1.55,95% 1.16 to 2.08). Being divorced was associated with increased odds of CHD (P<0.001) for both men and women while widowers were more likely to develop a stroke (P<0.001). Single men and women with myocardial infarction had increased mortality (OR 1.42, 95% CI 1.14 to 1.76) compared with married participants. 

    Conclusions: Marital status appears to influence CVD and prognosis after CVD. These findings may suggest that marital status should be considered in the risk assessment for CVD and outcomes of CVD based on marital status merits further investigation.

    Original languageEnglish
    Pages (from-to)1937-1948
    Number of pages12
    JournalHeart
    Volume104
    Issue number23
    DOIs
    Publication statusPublished - 1 Jan 2018

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