PT  - JOURNAL ARTICLE
AU  - Chun Wai Wong
AU  - Chun Shing Kwok
AU  - Aditya Narain
AU  - Martha Gulati
AU  - Anastasia S Mihalidou
AU  - Pensee Wu
AU  - Mirvat Alasnag
AU  - Phyo Kyaw Myint
AU  - Mamas A Mamas
TI  - Marital status and risk of cardiovascular diseases: a systematic review and meta-analysis
AID  - 10.1136/heartjnl-2018-313005
DP  - 2018 Dec 01
TA  - Heart
PG  - 1937--1948
VI  - 104
IP  - 23
4099  - http://heart.bmj.com/content/104/23/1937.short
4100  - http://heart.bmj.com/content/104/23/1937.full
SO  - Heart2018 Dec 01; 104
AB  - 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.