Prevent a heart attack: be married or cohabit

Robin Wulffson MD's picture
heart attack, myocardial infarction, living alone, acute coronary syndrome
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The month of February contains both Heart Health Month and Valentine’s Day. And a new study has found that there is a connection between having a significant other to share Valentine’s Day with and a health heart. The study found that being unmarried and living alone both increase the risk of having an acute coronary syndrome (ACS) event. In addition, single living increases the risk of dying within one year of the event. Finnish researchers published the results of their study online on January 30 in the European Journal of Preventive Cardiology.

The researchers noted that single living has been associated with a worse prognosis of acute coronary syndrome (ACS). Therefore, they conducted a study to evaluate the relationship between sociodemographic characteristics and morbidity, mortality, and case fatality of ACS in a large population. They accessed data from the population-based FINAMI myocardial infarction register (1993 through 2002) and recorded 15,330 cases of ACS among individuals aged 35–99 years in Finland.

The researchers reviewed incident cases of ACS compared with the populations of the four regions of Finland covered by the registry. Record linkage with the files of Statistics Finland provided information on sociodemographic characteristics (marital status and household size).

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The researchers found that both the ACS incidence and 28-day mortality rate were higher in unmarried men and women in all age groups. The pre-hospital case fatality of incident ACS was higher in single living and/or unmarried 35–64-year-old individuals. The 28-day case fatality was 26% in married men, 42% in men who had previously been married, and 51% in never-married men. Among women, the corresponding figures were 20% in married women, 32% in women who had previously been married, and 43% in never-married women. Most of these case fatality differences were apparent already at the pre-hospital phase. The only difference in treatment was that middle-aged men living alone or unmarried received thrombolysis less often. They noted that the disparities in ACS morbidity and mortality by marital status tended to widen during the study period.

The authors concluded that single living and/or being unmarried increases the risk of having a heart attack and worsens its prognosis both in men and women regardless of age. Most of the excess mortality appears already before the hospital admission and seems not to be related to differences in treatment of ACS.

Take home message:
This study reinforces the benefit of social interaction on one’s health. In addition to cohabiting with a significant other, other factors can improve heart health. These include a healthy lifestyle that encompasses regular exercise, a healthy diet, and avoidance of smoking.

Reference: European Journal of Preventive Cardiology

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