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Marriage Protects Men from Clinically Meaningful Elevations in C-Reactive Protein: Results from the National Social Life, Health, and Aging Project (NSHAP)

Sbarra, David A. PhD

doi: 10.1097/PSY.0b013e3181b4c4f2
Original Articles

Objective: To examine the association between marital status and C-reactive protein (CRP) levels after accounting for a range of relevant of demographic, subjective, and objective health indicators and psychological variables. Minor elevations in CRP (>3 mg/L) are a nonspecific marker of systemic inflammation and predict the future onset of cardiovascular disease.

Methods: Data from the National Social Life, Health, and Aging Project (NSHAP), a population-based study of community-dwelling older adults in the United States, were used to study CRP elevations. Home-based interviews were conducted with the entire NSHAP sample, a subset of whom provided whole blood samples for the CRP analyses. The final sample consisted of 1715 participants (n = 838 men) with an average age of 69.51 years. Multiple and logistic regression analyses were conducted, using CRP as a continuous and dichotomous outcome variable.

Results: Across the entire NSHAP sample, married men demonstrated the lowest levels of CRP. After adjusting for the competing predictors, marriage remained a unique protective factor against elevated CRP for men (odds ratio = 0.56, 95% Confidence Interval = 0.39–0.79). The absolute risk reduction (for being classified in the high-risk CRP group) associated with being a married man was roughly equivalent to that observed for adults who were normotensive, nonsmokers, and those with a normal body mass index.

Conclusions: Remaining married in late adulthood affords men unique and robust protection against elevated levels of CRP. The findings are discussed in terms of the pathways linking marital status and health outcomes among older adults.

AR = absolute risk; ARR = absolute risk reduction; BMI = body mass index; CRP = C-reactive protein; CVD = cardiovascular disease; NSHAP = National Social Life, Health, and Aging Project.

From the Department of Psychology, University of Arizona, Tucson, Arizona.

Address correspondence and reprint requests to David A. Sbarra, Department of Psychology, 1503 E. University Blvd., Tucson, Arizona 85721-0068. E-mail:

Received for publication February 19, 2009; revision received June 5, 2009.

NSHAP was supported by grants from the National Institutes of Health, including the National Institute on Aging, the Office of Research on Women's Health, the Office of AIDS Research, and the Office of Behavioral and Social Sciences Research (5R01 AG021487), and by the National Opinion Research Center (NORC). The NORC was responsible for the interview data collection. All other aspects of study design and data collection were conducted independent of the funding sources. For the present analyses, the publicly available version of the NSHAP data was used: Waite LJ, Laumann EO, Levinson W, et al. National Social Life, Health, and Aging Project (NSHAP) [computer file]. ICPSR20541-v3. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2008-12-08. doi:10.3886/ICPSR20541, 2008. The author of this paper had access to all publicly available data, and was responsible for all data analysis and report writing. While writing this manuscript, the author was supported, in part, by Grant AG#028454 from the National Institute of Aging and Grant MH#074637 from the National Institute of Mental Health.

Copyright © 2009 by American Psychosomatic Society
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