title: Does the risk of hospitalisation for ischaemic heart disease rise alreadybeforewidowhood?
abstract: The death of a spouse has been shown to increase mortality from various causes, including ischaemic heart disease. It is unclear, however, whether cardiac problems are already on the rise before widowhood.
  
  
  
  Using longitudinal register data of Finnish widows-to-be aged 65 and over at baseline (N=19 185), we assessed the risk of hospitalisation for ischaemic heart disease 18 months before and after widowhood. Hospital admissions were derived from national hospital discharge registers between 1996 and 2002. Analyses used population-averaged and fixed-effects logistic models, the latter of which controlled for unobserved time-invariant characteristics, such as genetic susceptibility, personality and behavioural and medical history.
  
  
  
  For men, fixed-effects model revealed that hospitalisation for ischaemic heart disease increased twofold already 0-3 monthsprior tothe death of a spouse (OR=2.09, 95% CI 1.22 to 3.60), relative to the period of 15-18 months before widowhood. It stayed at a heightened level up to 6 months following bereavement (OR=2.15, 95% CI 1.07 to 4.30). Among women, the fixed-effects analysis detected no statistically significant increase in hospitalisation for ischaemic heart disease before or after widowhood.
  
  
  
  These findings indicate that men are already vulnerable to cardiac problems before the death of a wife. Medical interventions and health counselling could be targeted to the husbands of terminally ill patients, in order to improve their cardiovascular health over the transition to widowhood.
authors.affiliation: Population Research Unit, Department of Social Research, University of Helsinki, Finland.
authors.forename: Elina
authors.initials: E
authors.lastname: Einiö
authors.affiliation: Population Research Unit, Department of Social Research, University of Helsinki, Finland.
authors.forename: Heta
authors.initials: H
authors.lastname: Moustgaard
authors.affiliation: Population Research Unit, Department of Social Research, University of Helsinki, Finland.|Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden.|Max Planck Institute for Demographic Research, Rostock, Germany.
authors.forename: Pekka
authors.initials: P
authors.lastname: Martikainen
authors.affiliation: Population Research Unit, Department of Social Research, University of Helsinki, Finland.|Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Taina
authors.initials: T
authors.lastname: Leinonen
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D001601:Bereavement; D005260:Female; D005387:Finland; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017202:Myocardial Ischemia / Q000453:epidemiology* / Q000523:psychology; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D018454:Spouses / Q000523:psychology / Q000706:statistics & numerical data*; D017805:Widowhood / Q000523:psychology / Q000706:statistics & numerical data*
keywords: Cardiovascular disease; Epidemiology of ageing; Epidemiology of cardiovascular disease; MEDICAL SOCIOLOGY FQ