Being married cuts your risk of having a heart attack and makes you more likely to survive cardiac arrest if it does happen - especially if you’re the wife.
A new study reveals that single and divorced people have the highest risk of fatal attacks at any age, with a greater chance of dying before getting to hospital.
The study is significant as most research suggests marriage may protect the health of men more than women. Experts say the benefits come from a positive effect on lifestyle, with married couples having more money, better health habits and social support than singles.
Unmarried people are also more likely to suffer depression, which has been shown to hamper recovery from heart attack. The large study from Finland found the benefits occurred as early as middle age, with couples who were married and cohabiting more likely to survive heart attacks at any stage.
The study looked at information on people over the age of 35 living in four geographical regions of Finland. All fatal and non-fatal cardiac events - known as acute cardiac syndromes or ACS - were included.
The register recorded 15,330 ACS events including heart attacks over the study period of ten years, with just over half (7,703) resulting in death within 28 days.
Events occurred almost equally among men and women, but they were 58-66% higher among unmarried men and 60-65% higher in unmarried women, than among married men and women in all age groups.
The differences in deaths before 28-days were even greater, being 60-168% higher in unmarried men and 71-175% higher in unmarried women, than among married men and women.
The 28-day death rate was roughly doubled for never married, single or divorced men and women aged 65-75 years compared with those who were married.
Wives came off best, with death rates of just 20% compared with 32% in divorced women and 43% among spinsters aged 35-64 years.
The rates for men aged 35-64 were 26% for husbands, 42% in divorcees and 51% for bachelors. The death rate of 35-64-year-old single men and women was higher than that of those living with one or more people.
Lead author Dr Aino Lammintausta from Turku University Hospital in Finland said previous research suggested being unmarried or living alone increased the chances of suffering and dying from a heart attack but rarely included data on women and older age groups.
She said, "Especially among middle-aged men and women, being married and cohabiting are associated with considerably better prognosis both before hospitalisation and after reaching hospital alive.
"Marriage seems to protect women even more than men from out-of-hospital death. The lower cardiac risks of married persons may result from a protective effect of marriage.
"For example, they may have a better financial status, better health habits, and higher levels of social support compared to the unmarried, thereby promoting their overall health."
Higher rates of depression among singles may play a part, although it is possible that people with poorer health may be more prone to staying unmarried or getting divorced.
Having someone close to raise the alarm during a heart attack could be important, she said. “It may be assumed that resuscitation or calling for help was initiated faster and more often among those married or cohabiting.”
Married people also seemed to get better treatment once in hospital - including therapy to re-open blocked arteries - and after discharge when they may be more likely to take their medication long-term, said the researchers.
A US study last month found being married could lead to a longer life by improving your chances of surviving middle age. It suggested for the first time that not having a spouse in midlife increases the risk of dying during those years, as unmarried people were almost three times as likely to die early than those who had been in a stable marriage throughout their adult life.