Mendes de Leon C F, Appels A W, Otten F W, Schouten E G
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06510.
Int J Epidemiol. 1992 Jun;21(3):460-6. doi: 10.1093/ije/21.3.460.
Between 1972 and 1974, a cardiovascular screening survey was conducted in a stratified sample of 3365 men aged 45-59 in Rotterdam, the Netherlands. Follow-up data collected in 1982 were used to examine the association between marital status and mortality and coronary heart disease while adjusting for various control variables. Nonmarried men had significantly higher relative risks (RR) (95% confidence interval (CI)) of 1.7 (95% CI: 1.2-2.3) and 2.2 (95% CI: 1.2-4.2) for all-cause mortality and coronary mortality than the married. Never married men showed the most consistent relationships with all-cause and coronary mortality, with RR of 2.3 (95% CI: 1.6-3.4) and 2.9 (95% CI: 1.4-6.2) respectively. The RR for these endpoints among the widowed and divorced were all close to unity, except for the risk of coronary mortality among the widowed, which was 2.9 (95% CI: 0.9-10.2). Not being married also increased the risk for fatal and total reinfarction, with RR of 3.6 (95% CI: 1.4-9.1) and 2.5 (95% CI: 1.1-5.6) respectively. The results suggest that in middle-aged Dutch males, the health consequences of not being married may differ for the never married, divorced, and widowed. Selective mating, differential lifestyles or health habits, and lack of social integration were offered as possible explanations.
1972年至1974年间，在荷兰鹿特丹对3365名年龄在45至59岁的男性进行了分层抽样心血管筛查调查。1982年收集的随访数据用于检验婚姻状况与死亡率及冠心病之间的关联，同时对各种控制变量进行了调整。未婚男性的全因死亡率和冠心病死亡率的相对风险（RR）（95%置信区间（CI））显著高于已婚男性，分别为1.7（95%CI：1.2 - 2.3）和2.2（95%CI：1.2 - 4.2）。从未结婚的男性与全因死亡率和冠心病死亡率的关系最为一致，RR分别为2.3（95%CI：1.6 - 3.4）和2.9（95%CI：1.4 - 6.2）。丧偶和离婚男性在这些终点事件上的RR均接近1，但丧偶男性的冠心病死亡率风险为2.9（95%CI：0.9 - 10.2）除外。未婚还会增加致命性再梗死和总再梗死的风险，RR分别为3.6（95%CI：1.4 - 9.1）和2.5（95%CI：1.1 - 5.6）。结果表明，在荷兰中年男性中，未婚对从未结婚、离婚和丧偶男性的健康影响可能有所不同。选择性交配、不同的生活方式或健康习惯以及缺乏社会融合被认为是可能的解释。
