title: Marital dissolution is followed by an increased incidence of stroke.
abstract: BACKGROUND
  Many studies have reported lower mortality in married people. The relation between marital status and incidence of haemorrhagic and ischaemic stroke is unclear. It is largely unknown whether the risk of stroke is increased the first years after divorce or death of spouse.
  
  
  METHODS
  Incidence of first-ever stroke (n = 6,184) was followed over 10 years in a cohort consisting of all 40- to 89-year-old inhabitants (n = 118,134) in the city of Malmö, Sweden. Marital dissolution (i.e. divorce or death of spouse) prior to the date of stroke was compared in a nested case-control design (3,134 initially married stroke cases, 9,402 initially married controls).
  
  
  RESULTS
  As compared to the married groups, the incidence of stroke was increased in divorced men and women (RR = 1.23, CI: 1.10-1.39 and RR = 1.26, CI: 1.12-1.41, respectively) and widowed men and women (RR = 1.13, CI: 0.99-1.28 and RR = 1.13, CI: 1.02-1.24, respectively) after adjustments for age, country of birth and socioeconomic indicators. The risk of stroke was not increased in never married men. Marital dissolution was followed by increased risk of stroke, which was significant for men (adjusted odds ratio: 1.23, CI: 1.03-1.5) and borderline significant for women below 65 years of age (odds ratio: 1.45, CI: 0.99-2.14).
  
  
  CONCLUSIONS
  The incidence of stroke is increased in divorced and widowed individuals. Never married men do not have an increased incidence. The risk of stroke is elevated during the first years after divorce or death of spouse.
authors.affiliation: Department of Community Medicine, Malmö University Hospital, Malmö, Sweden. Gunnar.Engstrom@smi.mas.lu.se
authors.forename: Gunnar
authors.initials: G
authors.lastname: Engström
authors.forename: Farhad Ali
authors.initials: FA
authors.lastname: Khan
authors.forename: Elisabet
authors.initials: E
authors.lastname: Zia
authors.forename: Ingela
authors.initials: I
authors.lastname: Jerntorp
authors.forename: Hélène
authors.initials: H
authors.lastname: Pessah-Rasmussen
authors.forename: Bo
authors.initials: B
authors.lastname: Norrving
authors.forename: Lars
authors.initials: L
authors.lastname: Janzon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000453:epidemiology / Q000523:psychology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D020300:Intracranial Hemorrhages / Q000453:epidemiology / Q000523:psychology; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D020521:Stroke / Q000453:epidemiology* / Q000523:psychology*; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D014504:Urban Health