Does Spousal Caregiving Increase Risk of Incident Myocardial Infarction and Stroke?: Evidence from a Nationally Representative Sample

Background: No study to date has investigated the effect of spousal caregiving on incident heart attack and stroke in a nationally representative sample. Methods: Stroke and heart attack-free participants in the U.S.-based Health and Retirement Study (HRS) aged ³50 and married at baseline (n=9,580) were followed, on average, 5.0 years between 2000 and 2008 for self-report of a fatal or non-fatal stroke or myocardial infarction (MI) (925 events). We defined caregiving as providing ³14 hours of care for instrumental/activities of daily living per week to a spouse, based on reports of the spouse who received the care. We used Cox proportional hazards models to predict risk of incident stroke or MI. Exposure and covariates (age; sex; race; Hispanic ethnicity; maternal and paternal education; height; spouse education; Southern birthplace and current residence; income; wealth; current and ever smoking status; sleep status; alcohol; self assessed health; functional limitations; BMI; depression; diabetes and hypertension) were time-updated. We also examined models stratified by sex, race, and age (< & ³65 years old). Results: Providing ³14 hours of care per week was associated with an increased risk of first stroke or MI (HR: 1.42, CI: 1.04-1.94). The risk of first stroke or MI was even higher among men (HR=1.52 CI:1.04, 2.18) and men aged ≥65 (HR=1.53 CI:1.00, 2.32), though not among any other models stratified by sex, race, or age. Conclusions: Spousal caregiving poses an important independent risk of new onset cardiovascular events for U.S. adults.