Marital status and risk of out-of-hospital sudden cardiac arrest in the population

Eur J Cardiovasc Prev Rehabil. 2008 Oct;15(5):577-82. doi: 10.1097/HJR.0b013e3283083e04.


Background: We have recently reported on the association between clinical depression and out-of-hospital sudden cardiac arrest (SCA). In this study, we extend our research on the contribution of psychosocial characteristics to SCA, by examining the association between marital status and out-of-hospital SCA.

Design: A large case-control study of risk factors for incident SCA including 2,119 cases and 4,042-matched controls.

Methods: Participants were enrollees of a health maintenance organization (USA). Cases experienced SCA between 1980 and 1994 (mean age of 67 years). Controls were a stratified random sample of enrollees, with the strata defined by age, sex, earlier heart disease, and calendar year. The marital status at the time of the SCA or a comparable index date for controls was assessed using ambulatory care medical records. Conditional logistic regression was used to estimate odds ratio and its 95% confidence interval.

Results: Cases were more likely to be unmarried than the controls (30.2% vs. 21.0%), defined as being separated or divorced (10.0% vs. 7.0%), single (5.0% vs. 3.6%) or widowed (15.2% vs. 10.4%). Unmarried participants had a higher risk of SCA (odds ratio: 1.53; 95% confidence interval: 1.33-1.76), after adjustment for SCA risk factors. Consistent findings were observed according to sex, older age (>70 years), earlier coronary heart disease and the presence of clinical depression. Those who were both unmarried and clinically depressed had the highest risk of SCA.

Conclusion: These data support an association between marital status and SCA.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Case-Control Studies
  • Death, Sudden, Cardiac / etiology*
  • Depression / complications
  • Female
  • Heart Diseases / complications
  • Humans
  • Logistic Models
  • Male
  • Marital Status*
  • Middle Aged
  • Odds Ratio
  • Risk Assessment
  • Risk Factors