Abstract
BackgroundTo investigate the associations of marital status with major clinical outcomes including type 2 diabetes (T2D), hypertension, cardiovascular disease (CVD) and all-cause mortality.MethodsThe study cohort (1999–2014) included 9,737 (45% male) Iranian adults with a mean age of 47.6 years. Marital status was defined as married versus never married, divorced and widowed. The relationship between marital status and the four above mentioned outcomes were investigated using Cox regression models adjusted for the main confounders, specific to each outcome.ResultsAfter more than 12 years of follow-up, 1,889 (883 men) individuals developed hypertension, 1,038 (468 men) T2D, 1015 (597 men) CVD and 668 (409 men) all-cause mortality. Compared with married, being never married in men was associated with higher risk of hypertension [hazard ratio (HR): 1.55; 95% confidence interval (CI), 1.11–2.16] and all-cause mortality (2.17; 0.95–5.00; p-value = 0.066) after adjusting for confounders. Among women, compared with married status, widowed status was associated with a lower risk of T2D (0.74; 0.56–0.97) in the confounders adjusted model. Moreover, never married women had a lower risk of hypertension (0.58; 0.37–0.90) compared to married ones in the age adjusted model, a finding that did not achieve significance, after further adjustment for confounders.ConclusionWe found that the relationship between marital status and health outcomes varied by gender. Being never married was an important risk factor for hypertension and tended to be a significant risk factor for mortality in men. However, among women, being widowed was associated with a lower risk of T2D.
Highlights
Marriage, since ancient times, has always been a fundamental social institution and plays an important role in the lives of most people[1].Over the last half-century, numerous studies from different disciplines have investigated relations between marital status and various aspects of health, including cardiovascular, immune, psychiatric and behavioral-related indices [2]
Compared with married, being never married in men was associated with higher risk of hypertension [hazard ratio (HR): 1.55; 95% confidence interval (CI), 1.11–2.16] and all-cause mortality (2.17; 0.95–5.00; p-value = 0.066) after adjusting for confounders
A prospective study of Atherosclerosis Risk in Communities (ARIC) data [9]found that marital status was not associated with hypertension, but among women, remaining single throughout the study period was associated with an increased risk of developing type 2 diabetes (T2D).A recent study showed that not being married, and widowhood was associated with an increased risk of T2D in men [10].On the other hand, the meanings of marriage, gender roles and family structure have changed considerably over the last few decades [11]
Summary
Since ancient times, has always been a fundamental social institution and plays an important role in the lives of most people[1].Over the last half-century, numerous studies from different disciplines have investigated relations between marital status and various aspects of health, including cardiovascular, immune, psychiatric and behavioral-related indices [2]. A meta-analysis of 34 studies with more than two million participants has demonstrated the influence of marital status on the incidence of cardiovascular disease (CVD) and the prognosis after CVD [6] The results of this meta-analysis showed that unmarried participants had increased odds of CVDs, compared with married participants. A prospective study of Atherosclerosis Risk in Communities (ARIC) data [9]found that marital status was not associated with hypertension, but among women, remaining single throughout the study period was associated with an increased risk of developing T2D.A recent study showed that not being married, and widowhood was associated with an increased risk of T2D in men [10].On the other hand, the meanings of marriage, gender roles and family structure have changed considerably over the last few decades [11]. To investigate the associations of marital status with major clinical outcomes including type 2 diabetes (T2D), hypertension, cardiovascular disease (CVD) and all-cause mortality
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
