Single men, unhappily married men may have higher risk of fatal stroke

The findings are based on earlier work in which researchers examined 10,059 civil servants and municipal workers (average age 49) who participated in the Israeli Ischemic Heart Disease Study in 1963. Using the national death registry and other records, researchers tracked the fate of the men through 1997, the last year for which underlying causes of death had been coded.

Among the men who in 1963 were single, 8.4 percent died of stroke in the following 34 years, compared with 7.1 percent of the married men. Considering age at death and adjusting for socioeconomic status, obesity, blood pressure, smoking habits and family size, as well as existing diabetes and heart disease at the time of the earlier survey, single men had a 64 percent higher risk of fatal stroke than did married men. That figure is comparable to the risk of fatal stroke faced by men with diabetes, said Uri Goldbourt, Ph.D., author of the study.

Furthermore, in 1965, the married men had been asked to evaluate their marriages as very successful, quite successful, not so successful, or unsuccessful. In an analysis of the 3.6 percent of men who had reported dissatisfaction in their marriage, adjusted risk of a fatal stroke was also 64 percent higher, compared with men who considered their marriages very successful.

"I had not expected that unsuccessful marriage would be of this statistical importance," said Goldbourt, a professor of epidemiology and preventive medicine at Tel Aviv University in Israel.

The new research has several limitations, he said, including a lack of data on nonfatal vs. fatal strokes and on participants' medical treatment after the first five years of the initial study. Women also weren't included.

While the effects of marital status and success may be similar in women, "there are still differences, and research on women is clearly needed," Goldbourt said.

The research is a snapshot of Israel from more than four decades ago, he said. "How much this reflects associations between being happily or relatively happily married and stroke-free survival in other populations, at later times, is not readily deduced."

Author disclosures can be found on the abstract.

The research was funded by a collaborative project of Hadassah Medical Organization, The Israeli Ministry of Health and the U.S. National Heart, Lung, and Blood Institute.