DURHAM, NC — Divorce is associated with an elevated risk of MI, and that risk may go up significantly with progressively greater "exposure" to it, suggests a prospective analysis of >15,000 people who had been married at some point and were followed for about 18 years[1].
The effect seemed much more pronounced in women, who showed an independently significant MI risk increase whether they had been divorced once (by 24%) or more than once (by 77%), compared with continuously married women. The risk elevation was significant in men only for those divorced more than once (by 30%), compared with continuously married men.
Moreover, "remarried women had risks that were similar in magnitude to divorced women, whereas men who remarried had no significant risk for acute MI," write the authors, led by Dr Matthew E Dupre (Duke University, Durham, NC), in the May 2015 issue of Circulation: Cardiovascular Quality and Outcomes.
"The results of this study contribute to mounting evidence that acute-MI risks associated with social stressors are of the relative magnitude of established risk factors such as smoking, diabetes mellitus, and hypertension."
The group prospectively analyzed 15,827 ever-married persons aged 45 to 80 years at baseline followed from 1992 to 2010; they were part of a larger, nationally representative US sample population assembled for the Health and Retirement Study (HRS).
About 14% of men and 19% of women in the cohort were divorced at baseline. Over 200,524 person-years of follow-up, 8% experienced an acute MI.
Hazard Ratio* (95% CI) for Acute MI by Marital Status and Number of Divorces
| Divorce Status | Women | Men |
| Divorced | 1.36 (1.04–1.78) | 1.27 (0.98–1.65) |
| Remarried | 1.35 (1.07–1.70) | 1.13 (0.96–1.34) |
| 1 Divorce | 1.24 (1.00–1.55) | 1.10 (0.92–1.30) |
| > 2 Divorces | 1.77 (1.30–2.41) | 1.30 (1.02–1.66) |
"Although marital events are not amenable to medical intervention, knowledge about the risks associated with divorce will be useful for personalizing care and preventing new or recurrent acute MI," the group writes.
"For example, we found that divorced women—particularly those who experienced multiple divorces—may benefit from additional screening and treatment for depression or other symptoms of distress."
The study was funded by the US National Institute on Aging. The authors had no relevant financial relationships.
Heartwire from Medscape © 2015
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Cite this: Divorce, Especially Multiple Divorces, an MI Risk Factor: Cohort Study - Medscape - Apr 23, 2015.
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