UK Edition
Divorce raises the danger of a second heart attack
Heart attack victims who are divorced are significantly more likely to suffer a second attack, a large study has found.
Research on 30,000 men and women who had experienced a heart attack found that those who had been through a divorce were 14 per cent more likely to suffer a second attack.
Experts said it was not clear whether the heartache of a marital breakup had a direct effect, or whether divorces were less likely to look after their health without a partner looking out for them.
The study by Karolinska University Hospital and Karolinska Institutet in Stockholm, Sweden, examined a number of socioeconomic factors, including disposable income and level of education, as well as marital status. Patients who had suffered a heart attack were tracked for four years after being discharged from a cardiac care unit.
In total, 2,405 patients (8 per cent of participants) suffered a heart attack or stroke. After adjusting for age, gender, smoking status, and socioeconomic status, being divorced was independent ly associated with a 14 per cent greater risk of a second event than being married.
Being wealthy was the best protection of all, the Swedish study found.
The group with the highest incomes had a 36 per cent lower risk of a second heart attack than those in the lowest quintile.
However, differences in education made little difference, according to research presented at the European Society of Cardiology Congress on Saturday.
Lead author Dr Joel Ohm, a physician at the Karolinska University Hospital and Karolinska Institutet in Stockholm, Sweden, said: “Are you rich or poor? Married or divorced? That might affect your risk of a second heart attack or stroke.”
It has long been known that healthy people in lower socioeconomic groups have a higher risk of developing heart disease. But there is less research looking at what happens once patients have suffered an attack.
Dr Ohm said doctors should ask patients about their marital status and lifestyle, in order to assess their socioeconomic profile - and risks of future attacks. But he said asking patients for salary details might be a step too far.
"Our study shows that in the years following a first myocardial infarction (heart attack), men and women with low socioeconomic status have a higher risk of suffering another heart attack or stroke. This is a new finding and suggests that socioeconomic status should be included in risk assessment for secondary prevention after a heart attack," he said.
"Even though health care providers are unlikely to keep track of their patients’ yearly salary, simple questions about other socioeconomic variables such as marital status and educational level could make a difference.”
Dr Ohm said current risk assessment tools did not properly assess the risks in patients who had already suffered a heart attack. Building a socioeconomic profile of a patient - by assessing details such as occupation and their home neighbourhood - could help doctors to judge risk more accurately, he said.
Experts said it was not clear why wealthier people were less likely to suffer a second attack. But they said previous research had suggested that those in lower socioeconomic groups had lower compliance to medication regimes.