Shelley Wood

March 28, 2014

WASHINGTON, DC — Smug marrieds have another reason to gloat: data from surveys of 3.5 million Americans suggest that married couples are 5% less likely to have CVD in various forms than single men and women[1].

The US data, collected at over 20 000 sites, adds to findings from previous studies hinting that being married or cohabitating may be cardioprotective, as well as reducing risks from other chronic diseases.

According to lead investigator Dr Carlos Alviar (NYU Langone Medical Center, New York), other studies have looked at smaller cohorts, focused on married vs unmarried subjects only, and have not addressed different forms of cardiovascular disease.

According to survey results that Alviar will present Saturday morning in a poster session here at the American College of Cardiology 2014 Scientific Sessions , 69% of those surveyed were married, 13 % were widowed, 8% were single, and 9% were divorced.

Overall, married subjects had lower rates of cerebrovascular disease, coronary artery disease (CAD), abdominal aortic aneurysm (AAA), and peripheral artery disease (PAD).

Percentage of People With CVD*

Disease Unmarried Married
Cerebrovascular disease 10.82 8.8
CAD 7.55 6.3
AAA 2.0 1.9
PAD 8.12 5.7

*All differences statistically significant

Digging deeper into marital status, investigators report that being married was associated with lower rates of all forms of the disease, as compared with being unmarried. But being divorced or widowed was associated with an increased risk of any form of vascular disease, compared with never being married—something seen in both men and women.

Investigators also looked at different types of cardiovascular disease and found that risks of AAA, cerebrovascular disease, and PAD were all reduced in married subjects. CAD rates were not much different for married vs single subjects. The biggest difference was seen for PAD, which was reduced by almost 20% in married subjects.

Commenting on the study, Dr Vera Bittner (University of Alabama, Birmingham) observed: "This . . . drives home the point that we cannot estimate CV risk purely on metabolic abnormalities that we can measure; psychosocial variables can also be very important. [This] adds to the literature on domains such as depression, hostility, stress without control, and social support and in general deserves further exploration."

Asked what might explain the benefits of marriage, Alviar noted that there are a number of potential factors. "Several studies have looked into this, and one of the theories is that maybe if you have a spouse you may be more willing to follow up medical appointments, be compliant with medications, and be compliant with a healthy diet and exercise—things like that. There are some plausible biological explanations based on prior studies that show that people who are married have lower levels of inflammation in the blood vessel, but it's really not clear what is the main link or causative agent for this association."

Full results from this study are being presented during ACC 2014 but were released early via a special preconference press briefing, focused on consumer-interest news.

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