Normandie Université, UNICAEN, UFR Santé, General Practice Department, 14000, Caen, France.
Association for Cardiac Research, 00198, Rome, Italy.
Ir J Med Sci. 2024 Oct;193(5):2249-2257. doi: 10.1007/s11845-024-03761-y. Epub 2024 Jul 16.
The impact of marital status on cardiovascular disease (CVD) remains controversial in the general population.
The present investigation sought to delineate the association between marital status and long-term major non-fatal and fatal CVD, along with all-cause mortality within the scope of the RIFLE project (Risk Factors and Life Expectancy).
We examined the incidences of CVD, including cerebrovascular accidents and coronary heart disease (CHD), as well as all-cause mortality. In total, 47,167 individuals (46% female, average age 50 ± 9 years) were included in the analysis. Marital status at inception was categorized into married (inclusive of married or cohabitating) versus unmarried cohorts (including widowed, separated, divorced, or single individuals).
Compared to their married counterparts, unmarried subjects demonstrated a heightened risk for CVD in both females and males. Throughout a median follow-up span of 7.4 years (interquartile range from 6 to 9 years), married participants, adjusting for standard risk factors, exhibited reduced mortality rates attributed to CHD [hazard ratio (HR) 0.54 (95% confidence interval (CI) 0.33-0.86)) and all causes (HR 0.75 (95% CI 0.62-0.91)] within the aggregate population; this reduction persisted for both CHD-specific [HR 0.39 (95% CI 0.51-0.90)]and all-cause mortality [HR 0.68 (95% CI 0.51-0.90)], independent of traditional risk factors in women. No associations were evident between matrimonial status and any measured outcomes in males.
Within primary care settings, marital status should be considered a potential correlate of long-term CHD and overall mortality risks, especially among women.
婚姻状况对一般人群中心血管疾病（CVD）的影响仍存在争议。
本研究旨在探讨婚姻状况与长期主要非致命性和致命性 CVD 以及 RIFLE 项目（危险因素和预期寿命）范围内全因死亡率之间的关联。
我们检查了 CVD 的发生率，包括脑血管意外和冠心病（CHD）以及全因死亡率。共有 47167 人（46%为女性，平均年龄 50±9 岁）纳入分析。发病时的婚姻状况分为已婚（包括已婚或同居）和未婚队列（包括丧偶、分居、离婚或单身人士）。
与已婚者相比，未婚者无论在女性还是男性中，发生 CVD 的风险均升高。在中位随访期 7.4 年（四分位间距 6-9 年）内，已婚参与者在调整了标准危险因素后，死亡率因 CHD 降低[风险比（HR）0.54（95%置信区间（CI）0.33-0.86）]和所有原因（HR 0.75（95% CI 0.62-0.91）]，在总人群中；这种降低在 CHD 特异性[HR 0.39（95% CI 0.51-0.90）]和全因死亡率[HR 0.68（95% CI 0.51-0.90）]方面均持续存在，且独立于女性的传统危险因素。婚姻状况与男性任何测量结果之间均无关联。
在初级保健环境中，婚姻状况应被视为长期 CHD 和总体死亡率风险的潜在相关因素，尤其是在女性中。
