Divorce Raises Risk of Heart Attack, Especially For Women

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Matthew E. Dupre, PhD Associate Professor of Medicine Department of Community and Family Medicine Department of Sociology Duke Clinical Research InstituteMedicalResearch.com Interview with: 
Matthew E. Dupre, PhD
Associate Professor of Medicine
Department of Community and Family Medicine
Department of Sociology
Duke Clinical Research Institute

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Dupre: The negative health consequences of divorce have been known for some time.  However, we showed that lifetime exposure to divorce can have a lasting impact on ones’ cardiovascular health, particularly in women.  Results from our study showed that risks for acute myocardial infarction (AMI) were significantly higher in women who had one divorce, two or more divorces, and among the remarried compared with continuously married women after adjusting for multiple risk factors.  Risks for AMI were elevated only in men with a history of two or more divorces relative to continuously married men. We were especially surprised to find that women who remarried had risks for AMI that were nearly equivalent to that of divorced women.  Men who remarried had no significant risk for acute myocardial infarction.

The results of this study provide strong evidence that cumulative exposure to divorce increases the risk of acute myocardial infarction in older adults.  Also somewhat unexpected was that the associations remained largely unchanged after accounting for a variety socioeconomic, psychosocial, behavioral, and physiological factors.  However, we lacked information on several factors that we suspect may have contributed to the risks related to divorce – such as elevated stress, anxiety, and the loss of social support; as well as possible changes is medication adherence or other prophylactic behaviors.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Dupre: Although marital loss is not a modifiable risk factor or amenable to medical intervention, increased knowledge about the risks associated with divorce can assist in clinical decision-making and improve quality of care.  For example, divorced women—particularly those who experience multiple divorces—may benefit from additional screening and/or treatment for depression or other symptoms of distress.  A greater recognition of acute and chronic social stressors such as divorce will help physicians identify and treat adults at potentially high risk of AMI, as well as provide patients a new, or heightened, awareness of how the social world can get under our skin and damage our heart.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Dupre: More research is needed to better understand the mechanisms at play.  A particularly important avenue of future research should investigate direct measures of physiological stress and possible changes in preventative health behaviors and the maintenance of existing conditions that increase risks for heart attack, such as hypertension and diabetes.

Citation:
Association Between Divorce and Risks for Acute Myocardial Infarction 

Matthew E. Dupre, PhD; Linda K. George, PhD; Guangya Liu, PhD; Eric D. Peterson, MD, MPH

Circ Cardiovasc Qual Outcomes. 2015;8:00-00.
DOI: 10.1161/CIRCOUTCOMES.114.001291

 

MedicalResearch.com Interview with:, & Matthew E. Dupre, PhD (2015). Divorce Raises Risk of Heart Attack, Especially For Women 

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