Many factors can influence whether you live or die after a stroke, including age, severity of the stroke and quality of care afterwards. Now, thanks to a Duke study, we can add marital status to the list.

A study published last month by Matthew Dupre, associate professor in community and family medicine, and Renato Lopes, professor of medicine, investigated how marital status affects stroke survival odds.The results of the study indicated that people who never married and people who had experienced "a marital dissolution" are more likely to die after suffering from a stroke than people who are stably married.

"This study adds to a growing body of research that shows how our social relationships can get under our skin and have immediate and lasting consequences for our health," Dupre said.

Dupre and Lopes decided to conduct this study after learning about recent research showing that divorce and widowhood can increase a person's risk of suffering from a serious health event like a heart attack.

In the United States, strokes are one of the leading causes of death and disability, and about 7 million adults alive at the moment have previously had a stroke.

Dupre and Lopes studied 2,351 adults who had at least one stroke in the past and had then been released from the hospital.

Their results indicated that regardless of whether or not someone is currently happily married, a person who has sustained multiple marital losses in the past is 39 percent more likely to die after a stroke. A person is also 71 percent more likely to die from a stroke if they have never been married at all. Subjects who had been divorced or widowed once had similarly heightened rates of death, at 23 and 25 percent increased likelihood.

Dupre noted that he and Lopes were surprised to find that remarriage did not appear to reduce the risks of stroke survival from previous marital losses.

A lack of children, limited social support and depression may be reasons for the difference, he explained. However, he said that people who may be at increased risk for death by stroke because of their marital status should be proactive in seeking out solutions.

"Those who have been divorced or widowed more than once should consider talking to their health care provider about ways to possibly reduce their risks and take steps to improve their prospects of survival," Dupre said.

Despite the study's results, the researchers did not necessarily recommend that people become or remain married purely to improve stroke survival. They said they hope, however, that health care providers can become better equipped to recognize and tailor treatments for patients who may be particularly susceptible to death after a stroke.

"We know from prior studies that the health risks related to widowhood, and particularly divorce, generally diminish over time," Dupre said.