Interview with Matthew E. Dupre, Ph.D. Duke University
What is the background for this study? What are the main findings?
Response: There have been a handful of
recent studies showing how divorce and widowhood increase one’s risk of
suffering a serious health event such as a heart attack or stroke. Our
research is the first to show that an individual’s marital history can
have significant consequences for their prognosis after having a stroke. We found that people who never married and those with a history of
marital loss were significantly more likely to die after suffering a
stroke than those who were stably married. We also found that adults who
experienced more than one divorce or widowhood in their lifetime were
about 50% more likely to die after having a stroke than those in a
long-term stable marriage. We were also somewhat surprised to find that
remarriage did not seem to reduce the risks from past marital losses.
MedicalResearch.com: What should readers take away from your report?
Response: This study adds to a growing body of
research showing how our social relationships can have immediate and
lasting consequences for our health. Based on our findings, it’s
important for people to understand that their marital history can impact
their recovery following a serious health event such as a stroke. In
particular, those who have been divorced or widowed
more than once should consider talking to their health care provider
about ways to possibly reduce their risks and take steps to improve
their prospects of long-term survival.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Our study was unique in that we
took into account a wide range of suspected mechanisms that may have
contributed to the associations. However, many of the associations
remained largely unchanged. Somewhat unexpectedly, we found that factors
such as income, health insurance, depressive mood, and a variety of
health behaviors did not fully account for the risks associated with a
history of marital loss. It may be that the acute and chronic stress
related to the loss of a spouse may have played a role—particularly
among those with multiple marital losses. We also suspect that marital
instability may have had negative consequences for one’s medication
adherence, healthcare utilization, and other behaviors for disease
management that may have impeded recovery. We clearly need more research
to fully understand what may be underlying these associations.
MedicalResearch.com: Is there anything else you would like to add?
Response: More research is needed to know the
full implications of these findings. We recognize that one’s marital
background is not a modifiable risk factor like diet or exercise;
however, we hope that this study brings a greater awareness of these
risks and encourages health care providers to better recognize and
tailor treatment for patients who may be particularly susceptible to
dying after having a stroke.
For instance, those who never marry or are without a spouse may benefit
from resources to improve their social support, which we know improves
the utilization of rehabilitative services, medication adherence, and
changes in unhealthy behaviors. More research is needed, however, to
know the full implications of our findings and to identify possible
avenues of intervention.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Marital History and Survival After Stroke
Matthew E. Dupre, Renato D. Lopes
Journal of the American Heart Association. 2016;5:e004647
Originally published December 14, 2016