Marital status and Vascular Disease

  • Título: Marital status and Vascular Disease
  • Fecha: 27-06-2014
  • Frank J Criado, MD, FACS,FSVM

    In a most interesting presentation Dr. Carlos Alviar has reported (at the 2014 annual meeting of the ACC) that being married is independently associated with a significantly reduced rate of vascular disease in all arterial territories, according to a population-based study of more than 3.5 million subjects. The “protective effect of marriage”was strongest in younger individuals.

    In a multi variate regression analysis adjusted for demographics and cardiovascular risk factors, married subjects under age 50 were 12% less likely to have prevalent vascular disease than were those who were single. The risk advantage diminished with advancing age such that married participants above age 70 years had a 4% lower risk of vascular disease than did those who were single, a difference that was statistically significant because of the huge size of the study population. And those who were single were at lower risk than were widowed or divorced subjects.

    Dr. Alviar presented an analysis ofslightly more than 3.5 million participants in the Life Line Screening DiabetesMellitus and Vascular Disease survey conducted during 2003-2008. Unlike mostother studies of the relationship between marital status and health, which havefocused on the risk of coronary disease, this study included screening for PAD,and cerebrovascular disease. Among participants of all ages, the risk ofprevalent vascular disease was 5% less in those who were married than in thosewho were single. The risk was 3.2% greater in subjects who were divorced thanin those who were single, and 5.1% greater in subjects who were widowed.

    The mean age of the study population was 63.7 years. Among women, 63.4% were married, 8.1% were single, 10.5% divorced, and 18% widowed. The male demographics were some what different: 80.4%of the men were married, 8.8% single, 6.1% divorced, and 4.7% were widowed. Being widowed was associated with a higher prevalence of diabetes, hypertension, physical inactivity, and dyslipidemia, although investigators adjusted for that in their multi variate analysis. Divorced subjects were more likely to be smokers and have a family history of premature cardiovascular disease.

    Dr. Alviar proposed as potential explanations for the reduced prevalence of vascular disease among married individuals their possibly lower levels of psychological and physical stress, better access to medical care, and improved compliance to medical advice and medications.

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