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On the approach for determining association between changes in marital quality and cardiovascular disease risk factors
  1. Mindy Marie Pike
  1. Master of Public Health Program, School of Medicine, Vanderbilt University, Nashville, TN 37203, USA
  1. Correspondence to Mindy Marie Pike, Master of Public Health Program, School of Medicine, Vanderbilt University, Nashville, TN 37203, USA; mindy.m.pike{at}vanderbilt.edu

https://doi.org/10.1136/jech-2018-210445

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    Bennett-Britton et al’s recently published study of the association between changes in marital quality and cardiovascular disease risk factors in men from the Avon Longitudinal Study of Parents and Children (ALSPAC study) provided a longitudinal representation of how marital quality affects cardiovascular health.1 Though the conclusions are important to social support and cardiovascular health, significant selection bias may have affected their results and related inferences.

    An important excluded population was divorced men. A total of 116 men (which would be 19% of the final study population) were excluded because they were not confirmed to be married and/or the …

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