Marriage tied to lower risk of fatal heart attacks and strokes

(Reuters Health) - People who are married may be less likely to develop cardiovascular disease or die from a heart attack or stroke than individuals who aren't, a research review suggests.

Researchers examined data from 34 previous studies involving more than two million people. Overall, they found that compared to married people, adults who were divorced, widowed or never married were 42 percent more likely to develop cardiovascular disease and 16 percent more likely to develop coronary artery disease.

Unmarried people were also 43 percent more likely to die from heart disease and 55 percent more likely to die from strokes, researchers report in the journal Heart.

While the study wasn't a controlled experiment designed to prove whether or how marriage might help improve heart health, there are many reasons marriage might have a protective effect including potentially more financial stability and social support, said senior study author Dr. Mamas Mamas of the University of Keele in the U.K.

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Signs you're headed for a heart attack

You get angry over the littlest things

Tend to morph into the Hulk when you’re upset? Those fiery emotions can drastically increase your risk for a heart attack. Researchers at the University of Australia questioned 313 patients who had suffered suspected heart attacks about their anger levels before the onset of symptoms. They found that patients were 8.5 times more likely to have a heart attack in the two hours following an intense outburst of anger, defined as “very angry, body tense, clenching fists or teeth.” The more often you’re angry, the higher your chances for a heart attack. These 15 doctor-approved tips to prevent heart disease could save your life.

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You spend most of your time in front of a screen

Yes, that includes working on your computer. A study from the University College London reports that people who watch TV or work on a computer for four or more hours a day increase their risk of an event associated with cardiovascular disease, like a heart attack, by 125 percent. Long periods of sitting deplete the body’s supply of lipoprotein lipase, an enzyme that breaks down fat and prevents clogged arteries. If you spend most of your day plopped behind a desk, take a brief walk after every 20 minutes or try a standing desk. You can burn 30 percent more calories when you stand than when you sit.  Here are a cardiologist’s tips for sneaking in exercise.

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You log less than six hours of sleep each night

Many adults struggle to get the recommended seven to nine hours of sleep each night, but consistently missing that mark could be deadly. A study published in the Scandinavian Journal of Work, Environment & Health found that Japanese men who got less than six hours of sleep were five times more likely to have a heart attack than men who slept seven or eight hours a night. Another study from Jichi Medical School in Tochigi, Japan, found the same risk applied to Japanese women who got less than six hours of sleep. Learn how to prevent heart disease with these 30 simple tips.

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You live in a smoggy area

Smog is just as bad for your heart as it is for your lungs. Researchers used hourly air pollution measurements in South Boston to determine how exposure to particulate matter (small combustion particles that come from fuel burning and vehicle emissions) affected patients in this area who had heart attacks. They found that exposure to high concentrations of air pollution increased the likelihood of a heart attack by 48 percent in the two hours before patients first experienced heart attack symptoms. The risk went up to 69 percent when people were exposed to high levels of air pollution for 24 hours before the onset of symptoms. Check out the Environmental Protection Agency’s website to see how smog affects your neighborhood.

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You're divorced

Divorce can cause literal heartache. Researchers at the Duke University School of Medicine conducted an 18-year-study of nearly 16,000 men and women between the ages of 45 and 80 who had been married at least once. Every two years, researchers assessed the participants’ marital status and overall health. Divorced women were 25 percent more likely to have a heart attack than those who stayed married. Women who had two or more divorces were 77 percent more likely to have a heart attack. As for the men, the risk of heart attack stayed the same regardless of whether they were married or divorced—at first. But if they divorced at least twice, their heart attack risk increased by 30 percent.

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It's Daylight Savings Time

When researchers examined three years of Michigan hospital records to track the number of heart attacks that required stent insertions, they found that the frequency of these procedures fluctuated when Daylight Saving Time started and ended. On the Monday after “springing ahead” an hour, there was an 24 percent increase in heart attacks. (However, on the Tuesday after “falling back,” there were 21 percent fewer daily heart attacks). Since the total heart attack counts for those weeks were not drastically different from other weeks, researchers determined that the time changes didn’t necessarily make the heart attacks happen, but rather made them likely to occur sooner than they otherwise would have. This is probably due to disrupted sleep-wake cycles and increased stress at the start of a new week of work. Here are tricks to make the Daylight Saving switch less toxic to your heart.

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You live in an area with extreme temperatures

Studies show that both extreme cold and extreme heat can put people at risk for heart attacks. Using data from cardiac patients in the Worcester Heart Attack Study, scientists found that exposure to temperatures lower than 17º F in the two days prior to a heart attack increased patients’ risk by 36 percent. On the other end of the spectrum, British researchers found that once the temperature reaches 68º F, each increase of 1.8º F increased the risk of heart attack by 2 percent over the next one to six hours. On the first day of a hot spell, that risk jumps up to 6.5 percent per 1.8º F increase. Learn what heart doctors do to protect their own hearts.

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"For example, it is well known that patients are more likely to take important medications after an event such as a heart attack or a stroke if they are married, perhaps because of spousal pressure," Mamas said by email. "Similarly, they are more likely to take part in rehabilitation which improves outcomes after strokes or heart attacks."

Having a spouse around may also help patients recognize early symptoms from heart disease or the start of a heart attack, Mamas added.

Marriage isn't the biggest predictor of heart disease, however. Well-known risk factors like age, sex, high blood pressure, elevated cholesterol, smoking and diabetes account for about 80 percent of the risk, researchers note.

All of the studies in the current analysis were published between 1963 and 2015 and included people ranging in age from 42 to 77 from Europe, Scandinavia, North America, the Middle East, and Asia.

Divorce was associated with 33 percent higher odds of death from coronary heart disease and a more than doubled risk of death from strokes, the study found. Men and women who divorced were also 35 percent more likely to develop heart disease than married people.

Widows, meanwhile, were 16 percent more likely to have a stroke than married couples, but they didn't appear to have an increased risk of heart attacks.

Even though previous research has linked marriage to better outcomes for patients with heart problems, the current study offers fresh evidence of the risk for people unmarried for different reasons, said Brian Chin, a psychology researcher at Carnegie Mellon University in Pittsburgh, Pennsylvania who wasn't involved in the study.

"Given that previous work has suggested that the health benefits of marriage are significantly stronger for men than women, it was especially surprising that this study found no differences between men and women in how marital status affected cardiovascular disease risk," Chin said by email.

Gender relations may still play a role in the different outcomes for married and unmarried patients, Dr. Stefania Basili of Sapienza University of Rome and colleagues write in an accompanying editorial.

"A wide range of behavioral factors, psychosocial processes, and personal and cultural factors can create, suppress or amplify underlying biological differences in cardiovascular disease," Basili and colleagues write.

Limitations of the study include the lack of data on same-sex couples or the quality of marital relationships, researchers note.

It's possible that single people might not take care of their heart health as much as married individuals, Mamas said.

Regardless of marital status, people can reduce their risk by leading a healthy lifestyle, not smoking, and getting regular physicals, Mamas added. Exercise is important, too.

"I often advise couples to exercise together because they are more likely to stick with it," Mamas said. "Go to the gym together, run together or cycle together - doing activities together strengthens the relationship and improves both partners' cardiovascular health."

SOURCE: http://bit.ly/2ysMBey Heart, released June 18, 2018.

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