Background The influence of marital status on the incidence of cardiovascular disease (CVD) and prognosis after CVD is inconclusive. We systematically reviewed the literature to determine how marital status influences CVD and prognosis after CVD. Methods A search of MEDLINE and Embase in January 2018 without language restriction was performed to identify studies that evaluated the association between marital status and risk of CVD. Search terms related to both marital status and CVD were used and included studies had to be prospective in design. The outcomes of interest were CVD, coronary heart disease (CHD) or stroke incidence and mortality. We performed random effects meta-analysis stratified by the types of population by calculating odds ratios (OR) and 95% confidence intervals (95% CI). Results Our analysis included 34 studies with more than two million participants. Compared with married participants, being unmarried (never married, divorced or widowed) was associated with increased odds of CVD (OR 1.42; 95% CI 1.00 to 2.01), CHD (OR 1.16,95% CI 1.04 to 1.28), CHD death (OR 1.43,95% CI 1.28 to 1.60) and stroke death (OR 1.55,95% 1.16 to 2.08). Being divorced was associated with increased odds of CHD (P Conclusions Marital status appears to influence CVD and prognosis after CVD. These findings may suggest that marital status should be considered in the risk assessment for CVD and outcomes of CVD based on marital status merits further investigation.

https://heart.bmj.com/content/heartjnl/104/23/1937.full.pdf

Marital status and risk of cardiovascular diseases: a systematic review and meta-analysis

Background: There is evidence showing that marital status (MS) and marital disruption (i.e., separation, divorce, and being widowed) are associated with poor physical health outcomes, incl...

Marital Status, Cardiovascular Diseases, and Cardiovascular Risk Factors: A Review of the Evidence.

Stroke is among the leading causes of disability and death in the United States, and racial differences are greater for stroke than for all other major chronic diseases. Considering the equally sizeable racial disparities in marital life and associated risks across adulthood, the current study hypothesizes that black-white differences in marital history play an important role in the large racial inequalities in the incidence of stroke. The major objective are to (i) demonstrate how marital history is associated with the incidence of stroke, (ii) examine how marital factors mediate and/or moderate racial disparities in stroke, and (iii) examine the factors that may explain the associations. Using retrospective and prospective data from the Health and Retirement Study (n = 23,289), the results show that non-Hispanic (NH) blacks have significantly higher rates of marital instability, greater numbers of health-risk factors, and substantially higher rates of stroke compared with NH whites. Contrary to the cumulative disadvantage hypothesis, findings from discrete-time-hazard models show that the effects of marital history are more pronounced for NH whites than for NH blacks. Risks for stroke were significantly higher in NH whites who were currently divorced, remarried, and widowed, as well as in those with a history of divorce or widowhood, compared with NH whites who were continuously married. In NH blacks, risks for stroke were elevated only in those who had either never married or had been widowed-with no significant risks attributable to divorce. The potential mechanisms underlying the associations are assessed, and the implications of the findings are discussed.

/pdf/race-marital-history-and-risks-for-stroke-in-us-older-adults-4o30yai797.pdf

Race, Marital History, and Risks for Stroke in US Older Adults

Purpose: Vitamin D deficiency is a global health problem that is associated with increased risks of major diseases. This study investigated the status of 25-hydroxyvitamin D [25(OH)D] and its demographic and lifestyle determinants among Korean adults. Methods: A total of 5,847 adults who had participated in the Korean National Health and Nutrition Examination Survey of 2008 (KNHANES) were included in the present study. Stepwise linear regression analysis was performed to determine the demographic and lifestyle determinants of 25(OH)D concentration. Results: The weighted prevalence (standard error) of 25(OH)D deficiency (＜20 ng/mL) was 49.9 (2.1)% among the males and 67.4 (1.7)% among the females. Severe 25(OH)D deficiencies (＜10 ng/mL) were found in 5.7 (0.8)% of the males and 11.1 (1.0)% of the females. These peaked in spring and winter. Only 12.2 (1.1)% of the males and 6.4 (0.6)% of the females exhibited 25(OH)D sufficiency (≥30 ng/mL). The correlates with higher 25(OH)D concentration for both genders included summer, fall (vs spring), the 60s age group (vs 20s), rural residence (vs urban), moderate and vigorous physical activity (vs sedentary), alcohol consumption, and multivitamin supplementation. Higher education and unmarried status were inversely associated with 25(OH)D concentration for both genders. The strongest predictors of 25(OH)D concentration were season and residential area. Conclusions: 25(OH)D deficiency is a prevalent condition in Korea. Understanding the determinants of 25(OH)D can facilitate identification of persons at risk of 25(OH)D deficiency.

/pdf/25-oh-d-status-and-demographic-and-lifestyle-determinants-of-2xz55dloo1.pdf

25(OH)D status and demographic and lifestyle determinants of 25(OH)D among Korean adults.

Background: Adherence to a Mediterranean dietary pattern is a well-established protective factor against cardiovascular disease (CVD). However, diet quality is only one aspect of the overall healthy lifestyle adopted by Mediterranean populations. The latter has never been evaluated as a multi-factorial composite lifestyle. Thus, the aim of the present study was to provide a broader picture of the Mediterranean lifestyle and its effects on CVD risk, among elderly individuals. Methods: During 2005–2015, 2,749 older (aged 65–100 years) from 21 Mediterranean islands (MEDIS) and the rural Mani region (Peloponnesus) of Greece were voluntarily enrolled onto the study. Dietary habits, physical activity status, socio-demographic characteristics, lifestyle parameters (sleep, smoking habits, social life and educational status) and clinical profile aspects were derived through standard procedures. Results: The overall prevalence of the traditional CVD risk factors were 62.3% for hypertension, 22.3% for diabetes mellitus (type 2) and 47.7% for hypercholesterolemia. The presence of diabetes mellitus was positively predicted by the geriatric depression scale (GDS) [odds ratio (OR) =1.13, 95% confidence interval (CI): 1.02–1.25] and by an urban residential environment (OR =2.57, 95% CI: 1.10–6.06) after adjusting for several confounders. Presence of hypertension was predicted by increasing age (OR =1.07, 95% CI: 1.02–1.12), increasing body mass index (BMI) (OR =1.12, 95% CI: 1.04–1.21), the habit of midday sleep (OR =2.07, 95% CI: 1.07–4.02) and inversely predicted by the frequency of socializing with friends (OR =0.767, 95% CI: 0.616–0.955). The estimated score in the GDS was the only independent positive predictor for the presence of hypercholesterolemia (OR =1.10, 95% CI: 1.01–1.21). Conclusions: Lifestyle parameters such as social life, midday sleep (siesta) and residential environment are strongly associated with the presence of CVD risk factors in elderly and should be part of broader CVD prevention strategies to reduce the burden of the disease.

Mediterranean lifestyle and cardiovascular disease prevention.

Marital status is related to cardiovascular disease (CVD) risk factors in Western countries. However, few studies have addressed the relationship between marital status and CVD risk factors in other populations. We investigated lifestyle and CVD risk factors relative to marital status among middle-aged Japanese men. We analyzed baseline data of 40-59-yr-old male workers who participated in the high-risk and population strategy for occupational health promotion (HIPOP-OHP) study. We compared lifestyle and CVD risk factors between men who were married (Group M; n=1,419, mean age 47.9 +/- 5.1 yr) and those who had never married (Group N; n=163, mean age 46.7 +/- 4.3 yr). Men in Group N were more likely to skip breakfast, work more shifts and exercise less. Current smoking rates, as well as average values of diastolic blood pressure (DBP), serum total cholesterol and fasting plasma glucose were also higher in Group N than in Group M. The proportion of participants with three or more CVD risk factors, namely smoking, hypertension, hypercholesterolemia and hyperglycemia was higher in Group N, than in Group M (12.9% vs. 5.0%, p<0.01). The difference between Groups M and N was more evident in the subgroup of living with others, than in the subgroup of living alone. Since men who have never married might be at higher risk for CVD, effort should be made to educate this population about decreasing lifestyle-related risk factors.

/pdf/marital-status-and-cardiovascular-risk-factors-among-middle-3pqu8mqh8h.pdf

Marital status and cardiovascular risk factors among middle-aged Japanese male workers: the High-risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) study.

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Marital status and cardiovascular risk factors among middle-aged Japanese male workers: the High-risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) study.