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Unmarried people at higher risk of death from heart failure, research finds

Unmarried people are at higher risk of death resulting from heart failure, researchers from the European Society of Cardiology have revealed.

Researchers in a posthoc analysis of the Extended Interdisciplinary Network Heart Failure (E-INH) study have found that unmarried people are at risk of death from heart failure.

In their study, they found that unmarried patients with heart failure appear to be less confident in managing their illness and more socially restricted than their married peers.

They said differences may contribute to lower long-term survival rates for unmarried patients.

According to the experts, a posthoc analysis of the Extended Interdisciplinary Network Heart Failure (E-INH) study, which looked into the prognostic relevance of marital status in patients with chronic heart failure, discovered that being single is associated with a worse prognosis in both the general population and patients with coronary artery disease.

“Spouses may assist with drug adherence, provide encouragement and help with developing healthier behaviours, all of which could affect longevity. We found that unmarried patients exhibited fewer social interactions than married patients and lacked the confidence to manage their heart failure. We are exploring, whether these factors could also partially explain the link with survival,” said Dr Fabian.

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Dr. Fabian Kerwagen was the study author and helps people manage long-term conditions at the Comprehensive Heart Failure Center at the University Hospital Wurzburg in Germany.

The scientific findings came from 1,022 patients hospitalized between 2004 and 2007 for decompensated heart failure.

It was disclosed that of 1,008 patients providing information on marital status, 633 (63 percent) were married and 375 (37 percent) were unmarried; including 195 widowed, 96 never married and 84 separated or divorced.

The researchers explain that social limitation refers to the extent to which heart failure symptoms affect patients’ ability to interact socially such as pursuing hobbies and recreational activities or visiting friends and family while self-efficacy describes patients’ perception of their ability to prevent heart failure exacerbations and manage complications.

 They observed that there were no differences between married and unmarried patients regarding the overall quality of life or depressed mood. However, the unmarried group scored worse on social limitations and self-efficacy compared with the married group.

They then highlighted that during 10 years of follow-up, 679 (67 percent) patients died.

Being unmarried versus married was associated with higher risks for all-cause death (hazard ratio [HR] 1.58, 95 percent confidence interval [CI] 1.31-1.92) and cardiovascular death (HR 1.83, 95 percent CI 1.38-2.42) while widowed patients carried the highest mortality risk, with hazard ratios of 1.70 and 2.22 for all-cause and cardiovascular death, respectively, compared to the married group.

“The connection between marriage and longevity indicates the importance of social support for patients with heart failure, a topic which has become even more relevant with social distancing during the pandemic.”

“Health professionals should consider asking patients about their marital status while recommending heart failure support groups to fill potential gaps as education is crucial, they need to boost patients’ confidence in their self-care abilities,” said Dr. Fabian.

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