Unmarried People At A Higher Risk Of Heart Failure Related Death; Study

Heart disease is the leading cause of death globally, claiming 17.3 million lives each year. The number is expected to reach 23.6 million by 2030.

According to a new study published by the European Society of Cardiology, unmarried patients with heart failure are less confident about managing their illness and are more socially restricted than their married counterparts. These differences may contribute to a lower long-term survival rate for unmarried patients [1].

What Does The Study Say?

• The E-INH study involved 1,022 patients hospitalized between 2004 and 2007 for decompensated heart failure. In the sample of 1,008 patients who reported their marital status, 633 (63%) were married, 375 (37%) were unmarried, including 195 widowed, 96 never married, and 84 separated or divorced.
• Among patients with heart failure, quality of life, social limitations, and self-efficacy were assessed. The term social limitation refers to how heart failure symptoms affect a patient's ability to interact socially, such as engaging in hobbies and recreational activities or visiting friends and family. Self-efficacy refers to a person's perception of their ability to prevent heart failure exacerbations and manage complications.
• There was no difference between married and unmarried patients in terms of overall quality of life or depression. In contrast, the unmarried group scored lower on social limitations and self-efficacy than the married group. During the ten years of follow-up, 679 (67%) of the patients died.
• The study found that being unmarried versus married was associated with a higher risk of death from any cause and cardiovascular death.
• Compared with married patients, widowed individuals had the highest mortality rates, with high hazard ratios for all-cause and cardiovascular mortality, respectively.

"Social support helps people manage long-term conditions. Spouses may assist with drug adherence, encourage, and help develop healthier behaviours, all of which could affect longevity. In this study, unmarried patients exhibited fewer social interactions than married patients. As a result, they lacked the confidence to manage their heart failure. We are exploring whether these factors could also partially explain the link with survival," said study author Dr Fabian Kerwagen of the Comprehensive Heart Failure Center at the University Hospital Wurzburg, Germany [2].

The association between marriage and longevity indicates the importance of social support for patients with heart failure, which has become even more relevant with the increasing social isolation during the pandemic. In order to fill potential gaps, health care professionals should ask patients about their marital status and wider social group and recommend heart failure support groups.

In addition to education, health care providers should also build patients' confidence in their self-care skills. Currently, researchers are developing a mobile health application that will assist heart failure patients in managing their condition on a daily basis [3].

What Are The Heart Disease Risk Factors That You Cannot Change?

• Age [4]
• Sex
• Race or ethnicity
• Family history

What Can You Do To Lower The Risk Of Heart Disease?

You can reduce your risk of heart disease by taking the following actions [5]:

• Don't smoke or use tobacco
• Control your blood pressure
• Keep your cholesterol and triglyceride levels under control
• Aim for at least 30 to 60 minutes of activity daily
• Eat a heart-healthy diet
• Maintain a healthy weight
• Get good quality sleep
• Manage stress
• Get regular health screenings

On A Final Note...

A number of studies have shown that being single is associated with a poorer prognosis both in the general population and among patients with coronary artery disease. On the other hand, marriage and longevity are related, suggesting that heart failure patients require social support. This topic has become even more relevant in the context of social distancing.