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 U.S. researchers followed stroke survivors for an average of five
years after the event and found those who were never married,
remarried, divorced or widowed had significantly higher risks of
dying compared to those who had a long-term stable marriage.
Losing two or more marriages to death or divorce raised the odds of
mortality after stroke still higher, though never-marrieds had the
highest risk of all.
“A handful of recent studies have shown how social stress, such as
job loss and marital loss, increase the risk of suffering a serious
health event such as a heart attack or stroke,” said lead study
author Matthew Dupre of the Duke Clinical Research Institute in
Durham, North Carolina.
For men and women who had never married, the risk of dying after a
stroke was 71 percent greater than those who were continuously
married. Those who were divorced, remarried or widowed were about 23
percent more likely to die after a stroke, though the risks
associated with divorce decreased over time.
Stroke is one of the top causes of death in the U.S. More than
800,000 adults will experience a stroke this year, according to the
American Heart Association, and about 7 million U.S. adults are
currently stroke survivors.
Obesity, high blood pressure and smoking are known risk factors for
having a stroke. Past research suggests that social support, such as
marriage, can also influence both risk for stroke and the likelihood
of recovery, Dupre and colleagues write in the Journal of the
American Heart Association.
“This is the first (study) to show that marital history can have
significant consequences for prognosis after a stroke,” Dupre told
Reuters Health. “And a somewhat unexpected finding was that
remarriage doesn’t seem to reduce the risks from past divorce or
widowhood.”
Dupre and colleague Renato Lopes investigated data from the Health
and Retirement Study, a survey by the National Institute of Aging
that follows U.S. adults older than age 50. They looked at 2,351
adults who experienced a stroke between 1992 and 2010 and documented
factors such as age, gender, race and ethnicity, geographic
location, education, household income, weight and chronic illness.
The researchers also tracked psycho-social factors such as having
children, nearby friends or relatives, depressive symptoms and
religious service attendance, as well as behavioral factors such as
smoking, drinking, exercise and hypertension medication adherence.
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Of the original group of stroke survivors, 1,362 died during the
follow-up period. Overall, those who died were likely to be older,
less educated and have lower levels of income. They also were more
likely to have no children, to have more depressive symptoms, more
limitations in their daily activity, other chronic illnesses, and
less likely to take blood pressure medication.
“A growing body of work shows how our social relationships have
immediate and lasting consequences for our health,” Dupre said.
“It’s important for stroke survivors to understand how their marital
history may impact their recovery.”
This study builds on previous research that indicates those with
marital loss are at the highest risk for cardiovascular disease.
People with multiple marital losses are the most vulnerable, said
Zhenmei Zhang at Michigan State University in East Lansing, who was
not involved with the study.
“People with multiple marital losses have a higher likelihood of
cardiovascular disease and will need significant formal and informal
care as they advance into old age,” she said.
More research is needed to understand the full implications of the
study, particularly related to social support and psychological
distress, Dupre said. The surveys are based on self-reported data
and don’t include information about the type or severity of stroke,
the treatment of hypertension or diabetes, and other factors such as
rehabilitation after a stroke.
“Until then, we have a greater awareness of this association and can
help health care providers better recognize and treat patients who
may be at an especially high risk of dying after suffering a
stroke,” he said.
SOURCE: http://bit.ly/1f4U4k9 Journal of the American Heart
Association, online December 14, 2016.
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