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

Chun Wai Wong, Chun Shing Kwok (Corresponding Author), Aditya Narain, Martha Gulati, Anastasia S. Mihalidou, Pensee Wu, Mirvat Alasnag, Phyo K. Myint, Mamas A. Mamas

Research output: Contribution to journalArticlepeer-review

113 Citations (Scopus)
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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<0.001) for both men and women while widowers were more likely to develop a stroke (P<0.001). Single men and women with myocardial infarction had increased mortality (OR 1.42, 95% CI 1.14 to 1.76) compared with married participants.

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.

Original languageEnglish
Pages (from-to)1937-1948
Number of pages12
Issue number23
Early online date19 Jun 2018
Publication statusPublished - Dec 2018

Bibliographical note

We acknowledge the ASPIRE Summer Studentship programme at Keele University for the support of this work.

This work is supported by the ASPIRE Summer Studentship programme at Keele University.


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