People with heart disease who are unmarried, in particular those who are widowed, may have a higher risk of dying than those who are married, according to a study published Wednesday in Journal of the American Heart Association.

Researchers have previously reported studies that found being divorced was associated with an overall greater risk of dying. This is the first study to show an association between marital status and heart disease-related death among patients with known or suspected coronary artery disease, the most common type of heart disease.

The study enrolled 6,051 patients who underwent a cardiac catheterization to find out if they had coronary artery disease. The procedure, which assesses how well the heart is working, involves inserting a thin, hollow tube called a catheter into a large blood vessel that leads to the heart.

The researchers followed the patients for 43 months. During that time, 1,085 patents died — 688 from cardiovascular disease and 272 from a heart attack. Statistical analyses showed that compared to married patients, being unmarried was associated with a 24 percent higher risk of death from any cause; a 45 percent higher risk of death from cardiovascular disease; and a 52 percent higher risk of dying from cardiovascular disease or a heart attack.

The risk of dying from cardiovascular disease or a heart attack also varied by previous marital status. Specifically, the risk was 40 percent higher for those who were never married; 41 percent higher for those who were divorced or separated; and 71 percent higher for those who had been widowed.

“I was somewhat surprised by the magnitude of the influence of being married [on heart patients],” said the study’s lead researcher Arshed Quyyumi, M.D., co-director of the Emory Clinical Cardiovascular Research Institute at Emory University in Atlanta, in a press release. “Social support provided by marriage, and perhaps many other benefits of companionship, are important for people with heart disease.”

The researchers suggest that it may be important for doctors to ask patients with coronary artery disease about their marital status. They also point to the need for future studies that evaluate programs that could help unmarried patients.

Because this was a retrospective analysis of patients treated at only one medical center, the findings do not apply to all patients with cardiovascular disease. Also, the study did not consider cohabitation and did not follow up with patients to see if their marital status had changed.

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