The study, published in the European Journal of Preventive Cardiology reveals that people who aren't married or live alone are at a significantly increased risk of developing myocardial infarction. The investigators found that married couples are linked with "considerably better prognosis of acute cardiac events both before hospitalization and after reaching the hospital alive".
They analyzed the FINAMI myocardial infarction register data between the years 1993 and 2002 to assess the incidence of heart attack among the population. They looked at the data among people aged 35+ who lived in four regions of Finland. The population database was cross-referenced to all incidences of acute cardiac syndromes (ACS).
The purpose of the study was to assess the differences in prognosis of incident acute coronary syndromes across a range of socio-demographic characteristics.
A total of 15,330 ACS events were recorded over the 10 year period, of which 7,703 resulted in death within a month of the event. They found that the number of events was almost equal among men and women.
However, they noticed that the ACS rate among unmarried women and men was roughly 60-65% higher than men or women who were married, regardless of age.
Death rates higher among those unmarried or living aloneThe death rate of unmarried men and women within a month of a heart attack was also found to be significantly greater too, compared to married couples: 60-168% higher among unmarried men and 71-175% higher among unmarried women.
The total ACS death rate among 65-74 year old married men was 866 per 100,000 every year, compared to 1,792 per 100,000 in unmarried men. This statistically higher rate was also found among unmarried women of the same age versus those who were married (493 per 100,000 versus 247 per 100,000 persons).
The case fatality rate of married men between ages 35 and 64 was 26% compared to 51% in men who had never married. For women, the corresponding rate was 20% versus 43%.
The authors said that while it was known that living alone or being single is a risk factor for cardiovascular mortality, no previous study had included data on all age-groups and women.
The reasons why unmarried people are at a higher risk of heart attack include:
- People with poor health are less likely to marry.
- Married people are generally wealthier and have better health habits, therefore making their overall health significantly better.
- Earlier intervention - having the spouse nearby. The authors concluded:
"It may be assumed that resuscitation or calling for help was initiated faster and more often among those married or cohabiting.We found that a larger proportion of married and cohabiting men received reperfusion therapy at acute stage which may contribute to their better survival after hospitalization.
Lower adherence to secondary preventive medications (aspirin, statins, beta-blockers, angiotensin converting enzyme inhibitors or angiotensin receptor blockers) among the unmarried may have an adverse effect on long-term prognosis."
Interestingly, whilst heart attack rates are lower among married couples, a previous study found that the spouses of people who have sudden heart attacks are at increased risk for depression, anxiety or suicide after the event.
Written by Joseph Nordqvist