In a recent study published in AJPM focusresearchers assessed associations between fatherhood and cardiovascular health (CVH), disease (CVD), and mortality.
Study: Fatherhood and Cardiovascular Health, Morbidity, and Mortality: Associations from the Multinational Study of Atherosclerosis. Image credit: Halfpoint/Shutterstock.com
Record
Cardiovascular disease is the leading cause of death in men. In 2021, men in the United States (US) had six years less life expectancy than women. This difference was very significant among ethnic and racial minorities.
CVH declines from late adolescence in men until their 30s, when most become fathers. Furthermore, paternity transition is associated with negative and positive changes in CVH.
Fatherhood has been linked to higher rates of cardiovascular disease (CVD) among Chinese men, while the opposite is seen in white individuals, suggesting racial and cultural disparities.
In addition, evidence suggests that fatherhood is associated with a lower risk of all-cause mortality. However, previous studies on paternity, CVD, cardiovascular health (CVH), and mortality have not comprehensively assessed CVH or included different ethnic and racial populations.
About the study
In the present study, researchers evaluated the associations between fatherhood and CVD, CVD, and mortality in a racially and ethnically diverse sample.
They used data from the Multinational Atherosclerosis Study, which included people without cardiovascular disease aged 45–84 years. Blacks, Hispanics, Whites, and Chinese were recruited between 2000 and 2002 in the US.
All men who had data on CVH and comorbidities and completed the family history interview were included in this study, while women were excluded.
Males were classified as non-fathers or fathers based on interview data. The age of the father at the birth of the first child, i.e. the onset of paternity, was determined.
CVH was assessed using the Life’s Essential 8 framework. It included measures of blood pressure, lipids, glucose levels, weight, sound sleep, nicotine avoidance, physical activity and diet. Sleep data was not available. Thus, data for seven measurements were used. A CVH score was calculated for each measurement and a mean overall CVH score was calculated.
Covariates included age, marital status, race/ethnicity, education, family income, depressive symptoms, alcohol consumption, and serum testosterone.
Participants were followed for medical events at 9-12 month intervals for 18 years. Associations of paternity status with all-cause mortality, CVD events, and CVD death were assessed using Cox proportional hazard regression models.
Foundings
In total, 2,814 men aged 62.2 years, on average, were included. Of those, 41% were White, 22% were Hispanic, 13% were Chinese, and 24% were Black.
Fathers were more likely to have a gross family income of $50,000 or greater, but were less likely to be White, have depressive symptoms, and have higher education than non-fathers. On average, participants became fathers at 27.6 years. There were significant differences in age of onset of fatherhood by race/ethnicity.
Overall CVH and nicotine exposure was worse among fathers than non-fathers. However, white fathers showed significantly worse CVH than white non-fathers. Additionally, nicotine exposure was higher among older individuals < 20 ετών κατά την έναρξη της πατρότητας σε σύγκριση με εκείνα που ήταν > 35 years old.
Those aged 20–24 years at the onset of fatherhood had lower CVH, blood sugar levels, body mass index (BMI) and nicotine exposure than those aged >35 years.
Black or Hispanic patients of age < 20 ή 20-24 ετών κατά την έναρξη της πατρότητας είχαν φτωχότερη CVH από εκείνους που ήταν ηλικίας > 35 years old.
Overall, 608 CVD events, 214 CVD deaths, and 854 deaths from other causes occurred during a mean follow-up of 17.6 years. Fathers age <20 κατά την έναρξη της πατρότητας εμφάνισαν αυξημένο ποσοστό θνησιμότητας από όλες τις αιτίες σε σύγκριση με εκείνους ηλικίας >35 in age-adjusted models.
In fully adjusted models, there were no associations between age at onset of fatherhood and all-cause mortality, CVD events, and CVD death.
In addition, fathers had a lower all-cause mortality rate than nonfathers in age-adjusted models but not in fully adjusted models. There was evidence of statistical interactions between race/ethnicity and fatherhood on all-cause mortality, which was reduced after adjustment.
Furthermore, no interactions were evident between race/ethnicity and paternity for CVD events or death. In addition, black fathers had a lower all-cause mortality rate than black nonfathers in age-adjusted models. However, this was moderated when adjusted for all covariates.
Finally, there were no differences in CVD, CVD mortality, and all-cause mortality between fathers and nonfathers who were White, Chinese, or Hispanic.
conclusions
In summary, the study observed poor CVH and increased nicotine exposure among fathers. Men, particularly blacks and Hispanics, with younger ages of onset of fatherhood (< 25 ετών) είχαν χειρότερο CVH από εκείνους με μεγαλύτερες ηλικίες έναρξης (> 35 years old).
Additionally, an interaction was found between race/ethnicity and paternity for all-cause mortality. Overall, fatherhood may be an important determinant of health, and understanding its impact may help improve men’s health.
