Abstract
BackgroundWe investigated the effects of marital status and education on the risk of acute myocardial infarction (AMI) in a large-scale case-control study in China.MethodsThis study was part of the INTER-HEART China case-control study. The main outcome measure was first AMI. Incident cases of AMI and control patients with no past history of heart disease were recruited. Controls were matching by age (±5 years) and sex. Marital status was combined into 2 categories: single and not single. Education level was classified into 2 categories: 8 years or less and more than 8 years.ResultsFrom 1999 to 2002, we recruited 2909 cases and 2947 controls from 17 cities. After adjustment for age, sex, BMI, psychosocial factors, lifestyle, other factors, and mutually for other risk factors, the odds ratio (OR) for AMI associated with being single was 1.51 (95% confidence interval: 1.18–1.93) overall, 1.19 (0.84–1.68; P = 0.072) in men and 2.00 (1.39–2.86; P < 0.0001) in women. The interaction of sex and marital status was statistically significant (P = 0.045). Compared with a high education level, a low education level increased the risk of AMI (1.45, 1.26–1.67); the odds ratios in men and women were 1.29 (1.09–1.52) and 1.55 (1.16–2.08), respectively. Single women with a low education level had a high risk of AMI (2.95, 1.99–4.37).ConclusionsBeing single was consistently associated with an increased risk for AMI, particularly in women. In addition, as compared with high education level, low education level was associated with a higher risk of AMI in both men and women.
Highlights
As compared with widowed, divorced, and single individuals, married people are more likely to engage in positive health behaviors and less likely to engage in negative health behaviors.[1,2,3] Evidence Western countries suggests that marriage is associated with health benefits among men, including decreased cardiovascular morbidity and mortality.[4]
INTER-HEART was a large, international, standardized, case-control study designed as a first step in assessing the importance of risk factors for acute myocardial infarction (AMI) worldwide
Low income level, history of hypertension, history of diabetes, and ApoB/ ApoA1 ratio were more frequent in cases than in controls (P < 0.05 for all comparisons)
Summary
As compared with widowed, divorced, and single individuals, married people are more likely to engage in positive health behaviors and less likely to engage in negative health behaviors.[1,2,3] Evidence Western countries suggests that marriage is associated with health benefits among men, including decreased cardiovascular morbidity and mortality.[4]. We investigated the effects of marital status and education on the risk of acute myocardial infarction (AMI) in a large-scale case-control study in China. After adjustment for age, sex, BMI, psychosocial factors, lifestyle, other factors, and mutually for other risk factors, the odds ratio (OR) for AMI associated with being single was 1.51 (95% confidence interval: 1.18–1.93) overall, 1.19 (0.84–1.68; P = 0.072) in men and 2.00 (1.39–2.86; P < 0.0001) in women. Compared with a high education level, a low education level increased the risk of AMI (1.45, 1.26–1.67); the odds ratios in men and women were 1.29 (1.09–1.52) and 1.55 (1.16–2.08), respectively. Single women with a low education level had a high risk of AMI (2.95, 1.99–4.37). As compared with high education level, low education level was associated with a higher risk of AMI in both men and women
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