Key result
Providing high-intensity unpaid care was not significantly associated with incident cardiovascular disease in either females (HR 1.27) or males (HR 0.82) compared to non-caregivers after adjusting for confounders.
Why the study?
Providing unpaid care is known to be stressful, but it remained unclear whether this caregiving is associated with incident cardiovascular disease.
Does providing unpaid care increase the risk of incident cardiovascular disease in Australian adults?
Cohort (n=11,123)
Does providing unpaid care increase the risk of incident cardiovascular disease in Australian adults?
Hazard Ratio: 1.27 (95% CI 0.83–1.95)
p-value: p=0.267
Providing unpaid care to an elderly or disabled relative was not significantly associated with an increased risk of incident cardiovascular disease among Australian adults.
High-intensity unpaid caregiving showed no CVD link in this cohort; hypothesis-generating and should not yet change clinical risk assessment.
BACKGROUND: Engaging in chronically stressful behaviours has been hypothesised to increase the risk of experiencing cardiovascular disease (CVD). Providing unpaid care is known to be a stressful activity, but it is not clear whether this caregiving is associated with CVD. This study filled a gap in the existing literature by examining the association between providing unpaid care and incident cardiovascular disease among a nationally representative sample of Australian adults. METHODS: 11,123 adult participants aged over 18 years from the Household Income and Labour Dynamics in Australia (HILDA) survey were followed for up to 14 years from baseline (2003) until 2017. Gender-stratified survival analysis models used self-reported caregiving and heart disease statuses as well as time-varying covariates, to assess the association between providing high-intensity or low-intensity unpaid care (to an elderly or disabled relative) and incident CVD in comparison with a non-caregiving control. RESULTS: Among females, there was weak evidence that CVD was associated with high-intensity unpaid care (HR = 1.27, 95% CI = [0.83, 1.95]) and no evidence for low-intensity unpaid care (HR = 0.79, 95% CI = [0.50, 1.26]) in comparison with non-carers after adjusting for confounders. There was no association between caregiving and incident CVD for high-intensity (HR = 0.82, 95% CI = [0.47, 1.42]) or low-intensity (HR = 0.84, 95% CI = [0.55, 1.28]) caregiving males in the adjusted models. CONCLUSIONS: These findings do not provide strong evidence to reject the null hypothesis that providing unpaid care does not increase risk of developing CVD in the Australian population. Given that these findings are somewhat inconsistent with the extant literature from other populations, further research is necessary, both in Australia and internationally, to build on the findings of this study and improve understanding of the nature of the association between caregiving and incident CVD.
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Lambrias et al. (2025) conducted a cohort in Incident cardiovascular disease (n=11,123). Unpaid caregiving (high-intensity ≥14 hours/week or low-intensity <14 hours/week) vs. No unpaid caregiving was evaluated on Incident cardiovascular disease (HR 1.27, 95% CI 0.83-1.95, p=0.267). Providing high-intensity unpaid care was not significantly associated with incident cardiovascular disease in either females (HR 1.27) or males (HR 0.82) compared to non-caregivers after adjusting for confounders.
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