It seems unlikely that marital status could influence the risk of death from heart disease, but new research from the University of Oxford in the UK has found that unmarried women are more likely to die from heart disease than women who are married.
This is according to a study recently published in the journal BMC Medicine.
Past research has found that married men have a lower risk of death from heart disease than unmarried men, but the research team, led by Sarah Floud, says that there have not been many large-scale studies that assess this link among women.
With this in mind, the investigators analyzed data from the UK's Million Women Study - a national health study involving more than 1.3 million women aged 50 years and over who were recruited between 1996 and 2001.
The women were required to complete a health questionnaire at the baseline of the study and were re-evaluated 3 years later.
Of the women who were surveyed for hospital admissions and deaths as a result of heart disease, 734,626 with a mean age of 60 were included in the University of Oxford's study.
Higher risk of heart disease-related death for unmarried women
During the follow-up period, 30,747 women developed heart disease and 2,148 women died from the condition.
The researchers found that women who were married or living with a partner had the same risk of developing heart disease as unmarried women.
However, they found that women who were married were 28% less likely to die from heart disease, compared with women who were unmarried.
These findings were significant even after the investigators took other influencing factors into account, including age, socioeconomic status and lifestyle.
The researchers say that the reason married women have a lower risk of death from heart disease may be because their spouse encourages them to respond to symptoms of the condition and seek medical treatment.
But the research team notes that the information available to them on medication use does not show that partnered women had greater adherence to medication regimes than unpartnered women.
Furthermore, the investigators say spouses may provide emotional support that helps their partner cope with the distress of having a cardiac event.
Commenting on the findings, Sarah Floud told Medical News Today:
"Our study results suggest that it is unlikely that the lower risk of death for married women is due to a lower risk of developing heart disease, and instead it appears to be related to a woman's response to the disease."
Limitations of the study
Discussing the limitations of this study, the investigators say that although marital status was relatively stable throughout the follow-up period, they did not know whether women who were unpartnered at study baseline were never married, divorced, separated or widowed.
- Heart disease is the leading cause of death for women in the US
- Only 54% of women recognize that heart disease is their number one killer
- Almost two thirds of women who die suddenly of coronary heart disease have no previous symptoms.
"This unpartnered category is therefore diverse and it could be that being divorced or widowed rather than never married places women at higher risk of heart disease," the study authors explain.
But they point out that past studies have shown little consistency in the link between heart disease-related death and the various unmarried states of women.
"However, we were able to limit bias associated with this by excluding women with pre-existing disease, and also through two sensitivity analyses that showed no material change in the adjusted risk estimates," the researchers write.
The link between marriage and health
This is not the first study to determine an association between marriage status and heart problems. Last year, Medical News Today reported on a study suggesting that both men and women who are married are at lower risk of fatal and non-fatal heart attack, compared with those who are unmarried.
But the researchers of this most recent investigation say that theirs is the first study of women to analyze the effect of marital status on both heart disease incidence and mortality in the same cohort.
Floud told us that in future studies, the team would like to determine whether married women have a lower risk of death from other causes, such as stroke and cancer.
Last year, Medical News Today reported on a study suggesting that married men and women with cancer are more likely to live longer, compared with cancer patients who are unmarried.
But it seems marriage can also negatively effect health. Last year, a study revealed that happily married couples are likely to gain more weight, compared with married couples who are unhappy.