Adults who had been divorced, widowed or never married had lower rates of survival after stroke vs. those who have been continuously married, according to new data.
“Studies have suggested that social support, such as marriage, can have a significant impact on treatment and prognosis in adults diagnosed with [CVD],” wrote Matthew E. Dupre, PhD, associate professor in the department of community and family medicine at Duke Clinical Research Institute, and Renato D. Lopes, MD, PhD, from the division of cardiology, department of medicine, Duke University Medical Center. “However, the extent to which marital history is associated with survival after a stroke remains largely unknown.”
Nationally representative data were used from the Health and Retirement Study for analysis. The cohort included 2,351 adults aged at least 41 years.
Current marital status was self-reported and labeled as never married, continuously married, remarried, divorced or widowed. Dupre and Lopes also collected information on the number of marital losses through divorce and widowing.
After adjusted for sociodemographic factors, compared with adults who were continuously married, risk for death after stroke was higher for those who were never married (HR = 1.71; 95% CI, 1.31-2.24), remarried (HR = 1.23; 95% CI, 1.06-1.44), divorced (HR = 1.23; 95% CI, 1.01-1.49) or widowed (HR = 1.25; 95% CI, 1.1-1.43).
When adjusting for more than a dozen explanatory variables, Dupre and Lopes found that adults who had never married and those who were unmarried after one divorce or widowhood were not at significantly higher risk for mortality than those who had been continuously married.
However, Dupre and Lopes also found that adults with two or more marital losses had a significantly greater risk for dying after stroke vs. those continuously married (HR = 1.41; 95% CI, 1.19-1.66).
There was no evidence that these risks differed by sex, race or ethnicity.
“Although marital events are not amendable to medical intervention or treatment, knowledge about the risks associated with marital life may be useful for personalizing care and improving prognoses for those who experience a stroke,” Dupre and Lopes wrote. “Greater recognition and understanding of these associations may enable healthcare providers to better identify and treat older adults with illness who are at potentially high risk of dying, as well as provide older adults a greater awareness of the risks associated with their marital status and background.” – by Cassie Homer
Disclosure: The researchers report no relevant financial disclosures.