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Does the risk of hospitalisation for ischaemic heart disease rise already before widowhood?
  1. Elina Einiö1,
  2. Heta Moustgaard1,
  3. Pekka Martikainen1,2,3,
  4. Taina Leinonen1,4
  1. 1Population Research Unit, Department of Social Research, University of Helsinki, Finland
  2. 2Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
  3. 3Max Planck Institute for Demographic Research, Rostock, Germany
  4. 4Finnish Institute of Occupational Health, Helsinki, Finland
  1. Correspondence to Dr Elina Einiö, Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, P.O.Box 18, FIN-00014 Finland; elina.einio{at}


Background 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.

Methods 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.

Results For men, fixed-effects model revealed that hospitalisation for ischaemic heart disease increased twofold already 0–3 months prior to the 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.

Conclusions 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.

  • Cardiovascular disease
  • Epidemiology of cardiovascular disease
  • Epidemiology of ageing

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  • Contributors EE planned the study, conducted the analyses and wrote the paper. HM contributed to planning and revision of the study. PM and TL contributed to revising the paper.

  • Funding The study was funded by the Academy of Finland and Signe and Ane Gyllenberg Foundation.

  • Competing interests None declared.

  • Ethics approval The permission number for the register-based data is TK-53-1236-15.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The longitudinal register-based data file can be accessed at Statistics Finland by agreeing to confidential conditions and restrictions of the register authorities involved (TK-53-1236-15).