Marriage, Living With Others Found Cardioprotective

February 01, 2013

HELSINKI, Finland — Being unmarried and living alone both apparently raise the risk of having an acute coronary syndrome (ACS) event and of dying one month or one year after the event, compared with being married or living with at least one other person, respectively, suggests a registry in Finland covering the years from 1993 to 2002 [1]. The increased risk in those groups cut across all adult age groups.

As reported by Dr Aino Lammintausta (Turku University Hospital, Finland) and associates January 31, 2013 in the European Journal of Preventive Cardiology, the FINAMI MI registry documented 15 330 cases of ACS among persons aged at least 35 years. The current analysis looked at incident cases of ACS compared with the populations of the four regions of Finland covered by the registry.

Adjusted for age, unmarried men were 58% to 66% more likely than married men and unmarried women 60% to 65% more likely than married women to have an ACS event.

Among all persons hospitalized with an ACS event, 28-day mortality was significantly and steeply higher for unmarried men and women than for married men and women.

Case Fatality* Rates 28 Days After Hospitalization for Acute Coronary Syndromes by Sex, Marital Status, and Household Size

Parameter Men, % (95% CI) Women, % (95% CI)
Marital status    
Married 26 (24–29) 20 (15–24)
Never married 51 (46–57) 43 (31–56)
Previously married 42 (37–47) 32 (25–39)
Household size    
Live with >2 others 31 (28–35) 21 (14–28)
Live with one other person 31 (28–34) 25 (19–31)
Live alone 49 (44–54) 43 (35–51)

*Case fatality=% of ACS events that were fatal

In addition, in analyses of the 35-to-64-year age group, mortality at one year was significantly higher for never-married men, at 55% (95% CI 50%–60%) than for previously married men, at 44% (95% CI 40%–49%); it was significantly lower for married men, at 29% (95% CI 27%-32%).

Similarly, one-year mortality was significantly higher for men who lived alone, at 52% (95% CI 48%-57%), and for women who lived alone, at 45% (95% CI 37%-53%), than for men or women, respectively, who lived with at least one other person.

For both living alone and being unmarried, most of the survival disadvantage at one year was related to persistently low case-fatality rates for married men and women and for households with at least two people, beginning in the prehospital phase, according to the group.

"The study was supported in part by the Finnish Foundation for Cardiovascular Research, Turku University Foundation, and the Paulo Foundation." The authors have no disclosures.