July 1, 2007
View Full PaperMarital Status, Marital Strain, and Risk of Coronary Heart Disease or Total Mortality: The Framingham Offspring Study
Key Result
Married men had a lower risk of death compared with unmarried men (HR 0.54; 95% CI 0.34-0.83), while women who self-silenced during conflict had four times the risk of dying (HR 4.01).
Study Design
Type
Cohort (n=3,682)
Structured PICO
Does marital status and marital strain affect the 10-year incidence of coronary heart disease or total mortality in adults?
P
Population
3,682 participants (mean age 48.5 years, 52% women) from the Framingham Offspring Study followed for 10 years to assess the impact of marital status and strain on incident CHD and mortality.
E
Exposure
Marital status (married) and specific aspects of marital strain (e.g., self-silencing during conflict, wives upset by work)
C
Comparator
Unmarried status, or absence of specific marital strains
O
Outcome
10-year coronary heart disease (CHD) incidence or total mortalityhard clinical
Marital strain, such as self-silencing in women and spousal work stress in men, is associated with significantly increased risks of mortality and incident CHD.
Main Result
Hazard Ratio: 0.54 (95% CI 0.34–0.83)
Abstract
OBJECTIVE: To determine if marriage and marital strain are related to the 10-year coronary heart disease (CHD) incidence or total mortality. Research has demonstrated associations between marital strain and prognosis of heart disease, but little research has addressed the association between specific aspects of marital strain and incident CHD. METHODS: From 1984 to 1987, 3682 participants (mean age 48.5 +/- 10.1 (standard deviation) years; 52% women) of the Framingham Offspring Study were examined; measures of marital status, marital strain, and risk factors for CHD were collected at the baseline examination. The present study describes the 10-year follow-up for incident CHD and total mortality. RESULTS: After adjusting for age, systolic blood pressure, body mass index, cigarette smoking, diabetes, and total cholesterol/high density cholesterol, the married men compared with unmarried men were almost half as likely to die during follow-up (hazard ratio (HR) = 0.54; 95% confidence interval (CI): 0.34-0.83). Women who "self-silenced" during conflict with their spouse, compared with women who did not, had four times the risk of dying (HR = 4.01; 95% CI: 1.75-9.20). Men with wives who were upset by work were 2.7 times more likely to develop CHD (HR = 2.71; 95% CI: 1.22-6.03). Marital happiness, satisfaction, and disagreements were not related to the development of CHD or death in men or women. CONCLUSIONS: Our study suggests that marital communication, conflict, and strain are associated with adverse health outcomes. Further research into the influence of marital stress on health is merited.
Cite This Study
Eaker et al. (Sun,) conducted a cohort in Coronary heart disease and total mortality (n=3,682). Marital status and marital strain vs. Unmarried status or absence of specific marital strains was evaluated on 10-year total mortality (married vs unmarried men) (HR 0.54, 95% CI 0.34-0.83). Married men had a lower risk of death compared with unmarried men (HR 0.54; 95% CI 0.34-0.83), while women who self-silenced during conflict had four times the risk of dying (HR 4.01).