WASHINGTON – Being married is independently associated with a significantly reduced rate of vascular disease across all arterial beds, according to a population-based study of more than 3.5 million subjects.
This apparent protective effect was strongest in younger individuals. In a multivariate regression analysis adjusted for demographics and cardiovascular risk factors, married subjects under age 50 years were 12% less likely to have prevalent vascular disease than were those who were single. The risk advantage shrank 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. Carlos L. Alviar reported at the annual meeting of the American College of Cardiology.
He presented an analysis of slightly more than 3.5 million participants in the Life Line Screening Diabetes Mellitus and Vascular Disease survey conducted during 2003-2008. Unlike most other studies of the relationship between marital status and health, which have focused on the risk of coronary disease, this study also included screening for peripheral artery disease, abdominal aortic aneurysm, and cerebrovascular disease.
Among participants of all ages, the risk of prevalent vascular disease was 5% less in those who were married than in those who were single. The risk was 3.2% greater in subjects who were divorced than in those who were single, and 5.1% greater in subjects who were widowed, according to Dr. Alviar of New York University.
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 somewhat 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 multivariate 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 psychologic and physical stress, better access to medical care, and improved adherence to medication.
He reported having no financial disclosures regarding this study.