Marital status and outcomes in patients with cardiovascular disease

Trends Cardiovasc Med. 2020 May;30(4):215-220. doi: 10.1016/j.tcm.2019.05.012. Epub 2019 Jun 1.

Abstract

The national burden of cardiovascular disease (CVD) continues to impose significant risk of morbidity, mortality and increased costs. While traditional risk factors have been well-established, the evolving role of non-traditional risk factors, including socioeconomic and psychosocial factors, is increasingly being recognized. Several studies have acknowledged an association between marital status and the presence of CVD and its associated adverse outcomes. Across multiple U.S. and international cohorts, patients who are unmarried, including those who are divorced, separated, widowed, or never married, have an increased rate of adverse cardiovascular events when compared to their married counterparts. Some studies suggest that marriage may have a more protective role for men compared to women. Furthermore, dissatisfaction in a marriage and marriage quality have significant impact on cardiovascular risk. Psychosocial and socioeconomic factors, as well as other acute stressors, may contribute to the association between marital status and CVD outcomes, but the underlying mechanisms are not completely clear. Further investigation is required to identify potential targets for intervention and to determine whether more aggressive targeting of standard anti-atherosclerotic therapies can favorably impact CVD risk in unmarried patients.

Keywords: cardiovascular risk; marital status; non-traditional risk factors.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular Diseases / prevention & control
  • Cardiovascular Diseases / psychology
  • Female
  • Humans
  • Male
  • Marital Status*
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Social Determinants of Health*