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 / Updated  / Source: TODAY Contributor
By Linda Carroll

For women, divorce can be more than heart wrenching, it can be literally heart breaking, a new study finds.

Compared to women who remained married, those who divorced once were 25 percent more likely to have a heart attack, while those who divorced more than once were 77 percent more likely to have an attack, according to the study published Tuesday in the journal Circulation: Cardiovascular Quality and Outcomes.

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Men also experienced a rise in risk, but to a lesser degree and only after multiple divorces, researchers from Duke University reported. Making matters worse for women, remarrying didn’t lower the risk as it did for men.

“This study is the first to show that lifetime exposure to divorce can have a lasting effect on one’s cardiovascular health, particularly in women,” said the study’s lead author Matthew Dupre, an associate professor of medicine at Duke University. “The heart attack risks related to marital loss are similar to what we found for job loss and show how the social world can get under our skin and damage our heart.”

Dupre and his colleagues spent 18 years following a nationally representative cohort of more than 15,000 adults, aged 45 to 80 at the start of the study. During that time, there were a total of 1,211 heart attacks in the study volunteers.

“We were somewhat surprised to find that the associations remained largely unchanged after accounting for a variety of factors — such as changes in socioeconomic status, health insurance, emotional well-being, and numerous health behaviors such as exercise, smoking and excess drinking,” Dupre said.

And, Dupre said, the 77 percent increase in risk with multiple divorces was comparable to that of factors such as high blood pressure (73 percent), diabetes (81 percent(, and smoking (53 percent).

To put that increase in perspective, consider the example of white women, who in one recent study were found to have heart attacks at a rate of 21 per 10,000 women. A 77 percent increase would bump that number up more than 37 heart attacks per 10,000 women.

Dupre doesn’t know how divorce is raising the risk of heart attack. He suggested that more research should be done to look at the impact of factors such as elevated stress and anxiety, as well as loss of social support.

Dr. Karol Watson, a heart specialist unaffiliated with the new study, said she wasn’t at all surprised by the findings.

“Stress, anxiety and depression are bad for everyone, but they appear to be even more harmful for women,” said Watson, a professor of medicine at the University of California, Los Angeles, and director of the UCLA Barbara Streisand Women’s Heart Health Program and co-director of the UCLA Program in Preventive Cardiology. “What is most interesting is the lack of an effect from remarriage in women. It suggests we can’t remit all the harm by remarrying after divorce.”

So, does that mean women should just stay in bad marriages to protect their hearts?

Not at all, said Watson.

“Unhappy marriages are quite dangerous for women,” she said. “Positive relationships keep us all alive longer. Negative ones have much more impact on women than on men.”

Watson suggests that women under chronic stress — whether it’s due to divorce or other causes — find ways to ameliorate it.

“Stress is toxic,” she said. “There’s a lot of good data on the impact of mindfulness training and meditation. Exercise is also a big stress reducer.”

Other studies have shown that divorce ranks higher than starting a new job or even going to jail, in terms of setting the body up for illness, said Dr. Bruce Rollman, a professor of medicine, psychiatry, biomedical informatics and translational science at the University of Pittsburgh.

Rollman also suggests mindfulness behavioral therapy to reduce stress. But he says it's important to be aware that your risk of heart attack has gone up as a result of your divorce.

While you may not be able to reduce that risk factor, you might try to compensate by improving in other areas, like doing a better job at managing blood pressure or quitting smoking.

"There's data to show that these things work," Rollman said.