Divorce raises the danger of a second heart attack

Better off also less likely to suffer a return of condition, researchers find

PEOPLE who have suffered a heart attack and are divorced are significantly more likely than those who remain married to have a second attack, a study has found.

Research on 30,000 men and women in Sweden who had already experienced one heart attack found that those who had been through a divorce were 14 per cent more likely to suffer another.

Experts said it was not clear whether the heartache of marital breakup had a direct effect, or whether divorced people 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, examined 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 unit. In total, 2,405 patients (8 per cent) suffered a second heart attack or stroke.

After adjusting for age, gender, smoking and socioeconomic status, being divorced was associated with the 14 per cent greater risk of a second episode than for married participants.

Being wealthy was the best protection of all, the 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 income group.

However, education levels made little difference, according to research presented at the European Society of Cardiology Congress in Rome yesterday.

Lead author Dr Joel Ohm, a physician, 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 into what happens after patients have suffered an attack.

Dr Ohm said doctors should ask patients about their marital status and lifestyle, in order to assess their 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 [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.

Dr Ohm said current risk assessment tools did not properly address patients who had already suffered a heart attack. Building a socioeconomic profile of a patient 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 previous research has suggested the less well-off were less likely to comply with medication regimes.