In a new study, continuously married people were less likely to die than those who'd been divorced, widowed, or never married.


Your spouse may help you survive a stroke, say Duke University researchers. In a new study, people in stable marriages fared better than those who had been divorced, widowed, or never married, adding to a growing body of research about the health benefits of being in a loving relationship.

Stroke is one of the leading causes of death and disability in the United States, affecting nearly 800,000 adults every year. Survival and recovery from a stroke depends on several factors, including the quality of a person’s health care, how well they stick to their treatment plan, and whether they can reduce risk factors for future cardiovascular problems like high blood pressure, obesity, and smoking.

Studies have suggested that social support, like the kind that exists in a long-term marriage, can improve health in people with cardiovascular disease. They’ve also found that unmarried people have greater risks of stroke—which is closely related to and often overlaps with heart disease—than married ones. Until now, however, it wasn’t clear if marital status had an effect on survival after a stroke occured.

To investigate the potential link, researchers analyzed data from 2,351 adults, ages 41 and older, who reported having a stroke between 1992 and 2010. As part of the ongoing Health and Retirement study, these men and women also answered questions about their health and lifestyle—including their marital status—and were tracked for an average of five years each.

Over that time, 58 percent of the stroke victims died. And compared to people who’d been continuously married, those who’d never wed were 71 percent more likely to have passed away.

People who had lost a spouse were also at higher risk of dying after their stroke than folks who’d been hitched long-term: Those who’d been divorced or widowed once before had a 23 and 25 percent increased risk, respectively; the numbers rose to 39 and 40 percent if they’d had two or more previous spouses. And surprisingly, those increased risks remained whether people remarried or not.

The results were similar for men and women, and for different races and ethnicities. They were published today in the Journal of the American Heart Association.

"Our research is the first to show that current and past marital experiences can have significant consequences for one's prognosis after a stroke," said Matthew E. Dupre, Ph.D., lead author and associate professor in Duke’s Department of Community and Family Medicine, in a press release.

The authors note that their findings could not establish a cause-and-effect relationship between marriage and stroke survival, only an association. They also didn’t collect information about the quality of marriages—current or past—nor about the levels of stress and anxiety that followed participants’ strokes or marital losses.

They also point out that married people may be more likely to have children and a strong social network, have higher socioeconomic statuses, and be less likely to suffer from depression—all factors that likely play a role in better recovery after a stroke.

And in fact, after they controlled for these factors (as well as for smoking status, alcohol use, body mass index, and sedentary behavior) the differences in death rates between people who were married, never married, and once-divorced or widowed mostly disappeared.

Adults who’d been divorced or widowed more than once, however, were still significantly more likely to die—regardless of their current marital status.

While more research is needed to understand the study’s full implications, the authors hope their findings help health care professionals identify and treat older adults who are at potentially greater risk of dying. “Greater knowledge about the risks associated with marital life and marital loss may be useful for personalizing care, and improving outcomes for those who are recovering from a stroke,” said Dupre.

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