Heart Disease 'Survival Risk' for Widowed and Divorced Men

Peter Russell

June 05, 2019

Gender and marital status are important factors for whether patients survive some of the most common heart and circulatory diseases, according to new research.

The study, presented at the British Cardiovascular Society (BCS) Conference in Manchester found important differences in the death rates of men and women, particularly in relation to marital status, when living with heart failure, atrial fibrillation (AF), or following a heart attack.

"Research in this area has been building," said study author Dr Rahul Potluri, clinical lecturer in cardiology at Aston Medical School. "Long-term mortality after having a heart attack is dependent on how well patients look after themselves, take their medication, and make sure they're on top of their lifestyle factors," he told Medscape News UK.

Big Data

The researchers used data from more than 1.8 million people who were admitted to hospitals in the North of England with a heart attack, heart failure or AF between 2000 and 2014. The information was then analysed according to the ACALM (Algorithm for Comorbidities, Associations, Length of stay and Mortality) study protocol.

Widowers who had a heart attack were 11% more likely to die than widows, according to the researchers, who reported similar findings amongst widowed men with heart failure (10%) and AF (13%) compared to widowed women with the same conditions.

They also found that divorced men with AF were 14% more likely to die than divorced women.

Among married people with AF, men had a 6% higher risk of dying than women. However, that situation was quite different for those who were not married, where single men with heart failure actually had a 13% lower risk of death compared to single women.

A 'Holistic Approach' to Treatment

According to Dr Potluri, the findings were significant "because we showed that males, by and large, tended to do much worse than females across most of the groups, especially in the widowed category. But interestingly, females who are single with heart failure tended to do much worse."

This study followed on from previous work suggesting that being married could improve the chances of surviving a heart attack, particularly for women.

In the case of widowed men, Dr Potluri speculated that "they probably have lost psychosocial support, in which case they don't tend to look after themselves as well", and that "single women may be less able to look after themselves".

Overall, the take home message was that "the ability of psychosocial factors to majorly impact on long-term prognosis following heart conditions is very significant and is in parallel with the best available medical therapy".

He said: "The clinical message is that holistic care of a patient is very important. It's not just giving them medication and saying 'off you go' – it's about making sure they have the adequate support network in place to make sure that they look after themselves, to make sure that they take all their medication, and even a support group to talk to if they are not in a relationship, are widowed, or whatever their circumstances are."

Co-author Dr Ranjit More, consultant cardiologist at Blackpool Teaching Hospitals NHS Trust, added: "By identifying which groups of people have the worst outcomes, we can then push for healthcare professionals to encourage those people to become involved in group therapy and ensure they have adequate support networks in place to help deal with these serious, chronic medical conditions."

The impact of gender and marital status on long term mortality in patients with cardiovascular disease: insights utilising big data from the ACALM study, Potluri R et al, presented at the British Cardiovascular Society Conference 2019. Abstract.

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