Large study shows divorce a significant player in heart attack risk

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167641073Each year the CDC estimates that over 700,000 Americans will have a heart attack. Known risk factors include diabetes, stress, alcohol and smoking. Many of these factors are very tangible, for example being a habitual smoker. On the other hand, stress is very abstract, but still can be a very real detriment to the body. One source of stress that has long been associated with an increased risk of Acute Myocardial Infarction (AMI) commonly known as a heart attack is divorce, but the extent of which divorce may contribute to AMI risk was not previously known, until now.

A study published in this month s Circulation: Cardiovascular Quality and Outcomes shows that divorce may play a significant role in AMI risk, particularly for women (for more on women and heart disease, see our Dispatch item here). The researchers, from Duke University, followed almost 16,000 adults (ages 45-80 at baseline) for 18 years, from 1992-2010, with biennial check ups to compare AMI risk between divorced and continuously married people.

The results showed that when correcting for age and other risk factors, divorce was associated with elevated AMI risk, particularly for women. At one divorce, women have a significant increase in risk, about 24 percent higher. Furthermore, they saw a dose-dependent response, as a second divorce increased their risk further: two divorces was associated with a 77 percent increase in MI incidence thereafter. Also, for women, remarriage was not sufficient to rescue this risk, as those women who had remarried still had an elevated risk (about 35 percent) compared to the never-divorced group. The results for men were less pronounced, yet still significant: only after a second divorce were men s risks of AMI increased, by about 30 percent.

In the past, several studies have identified an association with AMI and divorce, however, this was the first to use a prospective cohort to analyze this question. The significance of this study is compounded by the ubiquity of divorce in America, which is generally cited as around 50%.

Despite its robust findings, the study should not be taken as fact just yet. The study did not examine reasons for nor a person s response to divorce. For example, previous studies suggest that post divorce behavior can include alcoholism, which is also a known risk factor AMI. Furthermore, the study did not include measurements for marriage quality nor did it differentiate divorced couples from legally separated ones. With these factors in mind, the study s results may be a candidate to fall under the common correlation vs. causation quandary.