Lifelong bachelorhood tied to mortality in men with heart failure
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NEW ORLEANS — Lifelong bachelor status was associated with elevated risk for mortality in men, but not women, with heart failure, researchers reported at the American College of Cardiology Scientific Session.
“Our team was interested in the connection between a person’s life circumstances and the trajectory of heart disease,” Katarina Leyba, MD, a resident physician at the University of Colorado, told Healio. “As doctors, it is important that we see the whole patient in front of us and that we consider the context of a person’s life, not just their list of medications. So we asked the question: How does relationship status affect outcomes in patients with heart failure? As our population is getting older and living longer, it is important to determine how to best support patients through the aging process, and that might not be as easy as taking a pill. We need to take a personalized and holistic approach, especially for patients with a chronic disease like heart failure.”
Leyba and colleagues analyzed 94 patients from the MESA cohort study who were diagnosed with HF by year 10 of the study. They compared survival rates after HF diagnosis by sex and marital status during a mean follow-up period of 4.7 years.
The marital status categories were married, widowed, divorced, separated or never married.
In a univariate analysis, those who were never married had elevated risk for mortality compared with those who were married (HR = 1.6; P = .02), which remained after adjustment for age (adjusted HR = 1.61; P = .02).
Compared with married men, men who were never married had more than twofold elevated risk for mortality (HR = 2.16; P = .009), but there was no difference between never-married and married women, according to the researchers.
In a multivariate analysis, never being married was associated with elevated risk for mortality in men compared with being currently married (aHR = 2.21; P = .008), but being widowed (P = .28), being divorced (P = .86) and being separated (P = .8) were not, Leyba and colleagues found.
“We were not surprised to find that never having been married had an impact on the clinical course of men with heart failure,” Leyba told Healio. “What was surprising to us was that there were outcomes differences even amongst men who were currently unpartnered. While patients who were lifelong bachelors were at increased risk of dying compared to men who were currently married, patients who were widowed, divorced or separated were not. In contrast, women with heart failure who had never been married did not appear to be at higher risk of death than those who had. These findings suggest that marriage has some kind of beneficial effect(s) for men that helps them survive longer after developing heart failure. At present, we have not identified precisely what these effects are, but they could include health-seeking behaviors, socioeconomic and family support in older age, or differences in factors like frailty, nutrition and mood. The lack of difference in survival between women with different marital histories could indicate either that those same factors are not as clinically beneficial in women or possibly that there are few deficits in those traits that are impacted through marriage.”
She said that “relationship history appears to be much more important in men than women. Recognizing these factors may help us identify new interpersonal strategies that could help improve the ability of patients to cope with heart failure.”
Reference:
- American College of Cardiology. www.acc.org/About-ACC/Press-Releases/2023/02/22/21/23/Lifelong-Bachelors-Face-Poorest-Prognosis-with-Heart-Failure#:~:text=Men%20who%20never%20married%20were,Session%20Together%20With%20the%20World. Published Feb. 23, 2023. Accessed March 1, 2023.
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Leyba K, et al. Abstract 1029-07. Presented at: American College of Cardiology Scientific Session; March 4-6, 2023; New Orleans (hybrid meeting).
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