Single, widowed or divorced? In combination with heart disease, this can have fatal consequences. Read the details here.
A number of studies have already been published in the past which have shown that marital status has an impact on cardiovascular health. This might influence both the risk of disease and the prognosis in the case of an existing disease.
The majority of published studies found that people who were not married—including those who had never been married and who were divorced or widowed—had a greater risk of developing cardiovascular disease than married people . One meta-analysis from 2018 shows: The risk of cardiovascular disease is 42% higher in comparison to non-married people. The risk specifically for the coronary heart disease was increased by 16% if the person was not married.
Relationship status and heart failure
Fabian Kerwagen from the German Center for Heart Failure in Würzburg (FZHI) is now investigating how marital status affects the prognosis in the case of a chronic heart attack heart failure affects. To do this, he analyzed data from the extended INH study (E-INH = Extended Interdisciplinary Network Heart Failure). The E-INH study involved just over 10,000 people who were hospitalized for congestive heart failure between 2004 and 2007. Of the approximately 1,008 persons affected who provided information on their marital status, 633 (63%) were married and 375 (37%) were unmarried, of whom 195 were widowed, 96 were never married and 84 were separated or divorced.
At the beginning of Study Quality of life, self-efficacy and social limitations were surveyed. The Kansas City Cardiomyopathy Questionnaire was used to measure self-efficacy. This is a questionnaire that was specially developed for patients with existing heart failure. Self-efficacy describes the extent to which patients feel able to prevent heart failure from worsening and to cope with complications. Social limitation was understood to mean the extent to which the consequences of heart failure impair participation in social life – for example the pursuit of hobbies and leisure activities or the interaction with friends and family.
Being single reduces life expectancy
The results, presented by Fabian Kerwagen at the Heart Failure Congress in May 2022 in Madrid, showed: There are no differences between married and unmarried patients in terms of general quality of life. However, the unmarried group performed worse than the married group on social limitations and self-efficacy. A total of 67% of patients died during the 10-year follow-up period. Unmarried people had an approximately 60% higher risk of death than married people. Widowed subjects had the highest risk.
The author assumed the reason for this was that unmarried patients with heart failure have less confidence in dealing with their disease and are more restricted in their social participation than married people. Social support helps people to cope with long-term illnesses, reports Fabian Kerwagen at the congress. As an example, he cites that spouses can help ensure medication is taken correctly and regularly, provide motivation, and lead by example in the development of healthy behaviors, all of which can impact life expectancy.
Social contact and self-confidence are the be-all and end-all
Being unmarried is associated with a higher risk of death in patients with heart failure. Reasons for this might be that unmarried patients with heart failure have less confidence in dealing with their disease and are more restricted in their social participation than married people.
Fabian Kerwagen recommends that the social environment should be considered and included when treating patients with heart failure. In his view, structured treatment programs with specialized heart failure nurses or heart failure support groups might help to fill any gaps. Educating people regarding life with heart failure, he stresses, is also crucial. At the same time, however, patients’ confidence in their ability to take care of themselves should be strengthened.
Image source: Todd Trapani, unsplash
