Marriage Dissatisfaction and the Risk of Sudden Cardiac Death Among Men

Conflicts in marriage have been associated with potential risk of cardiovascular disease; however, there is lack of prospective evidence on the association between marriage satisfaction and sudden cardiac death (SCD). We aimed to assess the association between perceived level of marriage satisfaction and risk of SCD. This study employed the Kuopio Ischemic Heart Disease study, an ongoing prospective population-based study in Finland. Perceived level of marriage satisfaction was assessed in 2,262 men using a well-structured self-administered questionnaire. Multivariable adjusted Cox regression models were used to estimate hazard ratios (95% confidence interval [CI]) for SCD. During a median follow-up period of 25.9 years, 239 SCDs were recorded. The mean age of participants was 53 (SD 5.2) years. On adjustment for several conventional cardiovascular risk factors, hazard ratio (95% CI) of SCD was 1.90 (CI 1.09 to 332; p = 0.02) for men who were dissatisfied with their marriage, compared with men who were satisfied with their marriage. The association remained consistent on further adjustment for preexisting coronary heart disease, socioeconomic status, and years of education 1.86 (CI 1.07 to 3.25; p = 0.03). In conclusion, dissatisfied marriage is associated with an increased risk of SCD among middle-aged Caucasian men, independent of conventional cardiovascular risk factors. (C) 2018 Elsevier Inc. All rights reserved.