Associations of marital status with diabetes, hypertension, cardiovascular disease and all-cause mortality: A long term follow-up study

Abstract

Background To investigate the associations of marital status with major clinical outcomes including type 2 diabetes (T2D), hypertension, cardiovascular disease (CVD) and all-cause mortality. Methods The study cohort (1999–2014) included 9,737 (45% male) Iranian adults with a mean age of 47.6 years. Marital status was defined as married versus never married, divorced and widowed. The relationship between marital status and the four above mentioned outcomes were investigated using Cox regression models adjusted for the main confounders, specific to each outcome. Results After more than 12 years of follow-up, 1,889 (883 men) individuals developed hypertension, 1,038 (468 men) T2D, 1015 (597 men) CVD and 668 (409 men) all-cause mortality. Compared with married, being never married in men was associated with higher risk of hypertension [hazard ratio (HR): 1.55; 95% confidence interval (CI), 1.11–2.16] and all-cause mortality (2.17; 0.95–5.00; p-value = 0.066) after adjusting for confounders. Among women, compared with married status, widowed status was associated with a lower risk of T2D (0.74; 0.56–0.97) in the confounders adjusted model. Moreover, never married women had a lower risk of hypertension (0.58; 0.37–0.90) compared to married ones in the age adjusted model, a finding that did not achieve significance, after further adjustment for confounders. Conclusion We found that the relationship between marital status and health outcomes varied by gender. Being never married was an important risk factor for hypertension and tended to be a significant risk factor for mortality in men. However, among women, being widowed was associated with a lower risk of T2D.

Sex-Specific Incidence Rates and Risk Factors for Hypertension During 13 Years of Follow-up: The Tehran Lipid and Glucose Study

“…We found a significant and strong interaction between sex and marital status. Although marital status was not a significant risk factor for hypertension development in this study, in line with a recent study [37], we found that married men had a 17% lower and married women had a 30% higher risk of incident hypertension. It is suggested that married men have better sleep patterns and lifestyle compared to never-married men [37].…”

Follow Up of Hypertensive Patients at Regional Hospital of Bafoussam, West Cameroon: Biochemical Profiles in Naive and Hypotensive Drug Treated Patients

“…According to a study conducted by Birditt et al [21], this result can be explained by negative relationships in the couple leading to stress that directly affects the cardiovascular system. These findings however, contrast with those of Ramezankhani et al [22] who concluded in their study that never having been married is an important risk factor for hypertension and cardiovascular disease. The distribution of participants by type of job revealed a significant difference between groups (p < 0.001).…”

Assessment of Risk of Type 2 Diabetes Among Adults of Banepa Municipality, Nepal: Community Based Cross-Sectional Study

“…This result was contradicted by the studies conducted in Iran. 21,23,24 BMI was highly associated with the risk of T2DM. The relation between BMI and risk of diabetes was demonstrated by Vaidya et al, 25 Pandya et al 26 and Gupta et al 17 Both insulin resistance and defective insulin secretion are most often seen among obese people, leading toward the occurrence of diabetes.…”