Unmarried people have higher risk of death with heart failure, shows study
The connection between marriage and longevity indicates the importance of social support for patients with heart failure.
What you need to know:
- The researchers explain that social limitation refers to the extent to which heart failure symptoms affect patients’ ability to interact socially such as pursuing hobbies and recreational activities or visiting friends and family while self-efficacy describes patients’ perception of their ability to prevent heart failure exacerbations and manage complications.
Researchers have found that unmarried patients with heart failure appear to be less confident in managing their illness and more socially restricted than their married peers.
The researchers at the European Society of Cardiology explain that these differences may contribute to lower long-term survival rates for unmarried patients.
According to Dr Fabian Kerwagen of the Comprehensive Heart Failure Center at the University Hospital Wurzburg in Germany, who is the study author, social support helps people manage long-term conditions.
“Spouses may assist with drug adherence, provide encouragement and help with developing healthier behaviours, all of which could affect longevity. We found that unmarried patients exhibited fewer social interactions than married patients and lacked the confidence to manage their heart failure. We are exploring, whether these factors could also partially explain the link with survival,” said Dr Fabian.
The experts point out that the posthoc analysis of the Extended Interdisciplinary Network Heart Failure (E-INH) study, which investigated the prognostic relevance of marital status in patients with chronic heart failure, found that being unmarried is an indicator of a less favourable prognosis both in the general population and in patients with coronary artery disease.
The scientific findings came from 1,022 patients hospitalised between 2004 and 2007 for decompensated heart failure.
It was disclosed that of 1,008 patients providing information on marital status, 633 (63 per cent) were married and 375 (37 per cent) were unmarried; including 195 widowed, 96 never married and 84 separated or divorced.
The researchers explain that social limitation refers to the extent to which heart failure symptoms affect patients’ ability to interact socially such as pursuing hobbies and recreational activities or visiting friends and family while self-efficacy describes patients’ perception of their ability to prevent heart failure exacerbations and manage complications.
They observed that there were no differences between married and unmarried patients regarding the overall quality of life or depressed mood. However, the unmarried group scored worse on social limitations and self-efficacy compared with the married group.
They then highlighted that during 10 years of follow-up, 679 (67 per cent) patients died.
Being unmarried versus married was associated with higher risks for all-cause death (hazard ratio [HR] 1.58, 95 per cent confidence interval [CI] 1.31-1.92) and cardiovascular death (HR 1.83, 95 per cent CI 1.38-2.42) while widowed patients carried the highest mortality risk, with hazard ratios of 1.70 and 2.22 for all-cause and cardiovascular death, respectively, compared to the married group.
“The connection between marriage and longevity indicates the importance of social support for patients with heart failure, a topic which has become even more relevant with social distancing during the pandemic.”
“Health professionals should consider asking patients about their marital status while recommending heart failure support groups to fill potential gaps as education is crucial, they need to boost patients’ confidence in their self-care abilities,” said Dr Fabian.
