Emory Clinical Cardiovascular Resaerch Institute, Emory University School of Medicine, Atlanta, GA, United States.
Division of Cardiology, Department of Medicine, Northwestern Feinberg School of Medicine, Chicago, IL, United States.
Trends Cardiovasc Med. 2020 May;30(4):215-220. doi: 10.1016/j.tcm.2019.05.012. Epub 2019 Jun 1.
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.
心血管疾病（CVD）给国家带来的负担持续增加，导致发病率、死亡率上升和医疗成本增加。虽然传统的风险因素已得到充分证实，但包括社会经济和心理社会因素在内的非传统风险因素的作用正日益受到关注。多项研究已经证实了婚姻状况与 CVD 及其相关不良结局之间存在关联。在美国和国际多个队列中，与已婚患者相比，未婚患者（包括离婚、分居、丧偶或未婚）发生不良心血管事件的风险更高。一些研究表明，与女性相比，婚姻对男性可能具有更具保护作用。此外，对婚姻的不满和婚姻质量对心血管风险有重大影响。心理社会和社会经济因素以及其他急性应激源可能导致婚姻状况与 CVD 结局之间存在关联，但潜在机制尚不完全清楚。需要进一步研究以确定潜在的干预目标，并确定是否更积极地针对标准抗动脉粥样硬化治疗可以有利地影响未婚患者的 CVD 风险。
