Marriage may protect against development of heart disease and stroke as well as influencing who is more likely to die of these diseases, new research suggests.
In contrast, those who are single, divorced or widowed are at heightened risk of succumbing to cardiac conditions.
As a result, marital status should be included in its own right as a risk factor for heart disease and stroke, the researchers have proposed.
Most cardiovascular disease can be attributed to well-known risk factors such as age, sex, high blood pressure, high cholesterol, smoking and diabetes – these factors account for 80 per cent of cases.
In the study, researchers at Keele University in the UK drew on 34 previously published studies involving more than 2 million people aged 42-77 from Europe, Scandinavia, North America, the Middle East and Asia.
Analysis of the data published in the journal Heart reveals that, compared with people who were married, those who were never married, divorced or widowed had a 42 per cent higher risk of developing cardiovascular disease and a 16 per cent higher risk of coronary artery disease.
Not being married was also associated with a heightened risk of dying from both coronary heart disease (42 per cent) and stroke (55 per cent).
Further analysis shows divorce is associated with a 35 per cent higher risk of developing heart disease for both men and women, while widowers of both sexes were 16 per cent more likely to have a stroke.
While there was no difference in the risk of death following a stroke between the married and the unmarried, this is not the case after a heart attack; the risk of which is significantly higher (42 per cent) among those who had never married.
Varying factors
The authors admit the methods used and adjustments made for potentially influential factors varied considerably across all the studies, which may have affected their results.
There was no information on same-sex partnerships or on the quality of marriage. Nor was the potential role of living with someone, as opposed to being married to them, explored.
There are various theories as to why marriage may be protective. These include earlier recognition of, and response to, health problems; better adherence to medication; better financial security; enhanced wellbeing; and better friendship networks.
“Future research should focus around whether marital status is a surrogate marker for other adverse health behaviour or cardiovascular risk profiles that underlies our reported findings or whether marital status should be considered as a risk factor by itself,” they conclude.
