Problems of the heart

Nicole M. King
December 15, 2014
Reproduced with Permission
Family Edge

The News Story - Seven ways to start preventing heart disease in your 20s

Cosmopolitan and other women-friendly (or should we say unfriendly?) publications recently picked up on a new campaign. "Fight the Ladykiller," created by C. Noel Bairey Merz, M.D. at the Cedars-Sinai Heart Institute, seeks to promote research into heart disease as a top killer of women.

"We've been slow to recognize heart disease as an epidemic in women," Dr. Merz toldCosmopolitan. In response, that salacious publication gave attention to some prevention methods. "Don't smoke," Keep a healthy weight," and "Eat the good stuff," made the list of seemingly commonsense tips, as did "Sweat a little" and "Use your vacay days."

What did the list leave off?

Given the source, it is no surprise that this list did not include "Get married!" But research reveals that as in men, marriage in women plays an important role in helping women survive a heart attack.

The New Research - Staying alive! Married women and heart attacks

Epidemiologists have known for some time that marriage shields men from lethal heart attacks. Now a new study concludes that wedlock affords women similar protection.

Completed by researchers from Oxford University, the new study probes the relationship between marital status and ischemic heart disease (IHD) among British women. The data for this study come from a very large sample of 734,626 women (average age of 59.7 years) without previous heart disease, stroke or cancer, all of whom were tracked for 8.8 years for hospital admissions and deaths.

The data suggest that married women are no less likely than unmarried women to have a heart attack (Relative Risk of 0.99). However, the data clearly indicate the risk of dying from heart disease runs much higher among British women living alone than it does for peers who are married or living with a partner (p < 0.0001).

Having identified this marital-status gap in IHD mortality rates, the researchers struggle to explain it. They recognize that "partnered women were less likely to live in deprived areas, to smoke, or to be physically inactive" than were their married peers. But these differences simply do not statistically account for the way marriage (and partnership) protects women from fatal heart disease. For the researchers find that once they have accounted for marital status, IHD rates "did not vary appreciably between women of different socio-economic groups or by lifestyle and other factors."

Efforts to explain this marital-status gap as a consequence of differing levels of social support likewise prove unavailing. The researchers report that "adjustment for variables which could indicate social interaction, including parity, participation in group activities and employment, and measures of well-being, such as reported happiness and treatment for depression, had little effect on the [IHD mortality] risk estimates."

The researchers are left baffled by "a substantial, unexplained lower risk of death from IHD for women who are married or living with a partner compared to women who are not." They can only wonder if they have unintentionally omitted from their analysis some "unmeasured aspects of social support, such as the frequency of social contact or the quality of social support."

But even if Oxford scholars cannot explain it, the protection that marriage affords women is real. It is truly heart-breaking that ever fewer women enjoy that protection as high divorce rates and low marriage rates continue to drive up the number of single-person households.