Conflicts in marriage have been associated with potential risk of cardiovascular disease; however, there is lack of prospective evidence on the association between marriage satisfaction and sudden cardiac death (SCD). We aimed to assess the association between perceived level of marriage satisfaction and risk of SCD.

               This study employed the Kuopio Ischemic Heart Disease (KIHD) study, an ongoing prospective population-based study in Finland. Perceived level of marriage satisfaction was assessed in 2262 men using a well-structured self-administered questionnaire.

                       Multivariable adjusted cox regression models were used to estimate hazard ratios (HRs) (95% CI) for SCD. During a median follow-up period of 25.9 years, 239 SCDs were recorded. The mean age of participants was 53 (SD 5.2) years. On adjustment for several conventional cardiovascular risk factors, HR (95% CI) of SCD was 1.90 (CI 1.09-3.32; p=0.02) for men who were dissatisfied with their marriage, compared to men who were satisfied with their marriage.

                The association remained consistent on further adjustment for pre-existing coronary heart disease, socioeconomic status and years of education 1.86 (CI 1.07 - 3.25; p=0.03). In conclusion, dissatisfied marriage is associated with an increased risk of SCD among middle-aged Caucasian men, independent of conventional cardiovascular risk factors.