Scientifically, relationships have been shown to affect everything from your cardiovascular health to your mental well-being; anecdotally, it can mess with everything from your brand of toothpaste to control of your DVR. So it should come as no surprise that marriage, divorce, and widowhood come with their own health-related complications.

Researchers are still trying to establish the why and how of it, but several studies have shown that your so-called “marital biography” may be critical your overall health (including singledom — that’s right, no one escapes unscathed). A new study in Circulation: Cardiovascular Quality and Outcomes throws another health impact into the marital mix: risk of heart attack (or acute myocardial infarction — MI). Researchers found that divorced men and women both had significantly higher risks of heart attack than their continuously married (neither divorced nor widowed) peers. Drawing on data collected over nearly two decades in the ongoing Health and Retirement Study, researchers were able to investigate the cumulative health effects of marriage and divorce. All told, the study included interviews with almost 16,000 married, widowed, and divorced participants aged 45 to 80. Between 1992 and 2010, each participant was interviewed six times on a wide range of topics.

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The results indicate that a history of divorce impacts the risk of heart attack, with effects varying by gender. Women who had divorced at least once were 24% more likely to experience an MI than those who had been continuously married; those divorced two or more times saw their risk increase to 77%. To put this in perspective, the latter number is comparable to risk associated with established factors like high blood pressure and diabetes. Men, on the other hand, only saw an escalated risk when divorced two or more times (increased to 30%).

These divorce-associated differences held even after researchers corrected for relevant demographic and physiological/health factors. Next to marital history, socioeconomic issues like employment history and status had the greatest further influence on men’s risks of AMI. For women, depressive symptoms were the primary additional contributing factor.

While many studies look only at the short term effects of divorce, researchers here were able to investigate the effects of remarriage as well. The gender difference stuck. Divorced men who remarried saw their risk of heart attack return to the level of their continuously married brethren — essentially, any MI related effects of divorce disappeared when a man once again found wedded bliss. Divorced women, on the other hand, retained their increased risk of heart attack even if they remarried. Hypotheses for this gender difference abound — one of the most popular/tiresome/ possibly true theory is that men are lazy and will only engage in healthy behaviors when they have a wife to make them do so — but this study can only tell us that a difference exists, not why it happens.

Speaking to Reuters Health, lead author Dr. Matthew Dupre explained:

“Earlier studies have suggested that marital loss has a greater impact on the health of women than men. The reasons for these differences are not entirely known; however, the prevailing view is that divorced women suffer greater economic losses and emotional distress than divorced men.”

It’s important to stress here that correlation does not equal causation; divorce won’t shatter your heart into a million pieces and send you spiraling towards an inevitable heart attack. Divorce is associated with a greater risk of heart attack, but researchers aren’t sure why. We know that high levels of stress can affect our hearts and, whether it’s contentious or amicable, dissolving a marriage is seldom stress-free. At this point, it’s completely unknown what it is about divorce that’s associated with the increased risk.

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Gaps in the data may also have influenced the results. Interviews lacked specific health questions regarding medical care and also failed to collect data on the emotional and social stress that may be linked with an increased risk of AMI, independent of marital status. The most glaring absence, however, is information on the quality of the marriage or why
participants got divorced. Did they marry too young? Did one of them fall ill? Did they lose their life’s savings betting on horses? Did they have obnoxious children?

So, okay: these findings suggest divorce may be bad for your heart health. Divorce (and its ripple effect of emotional, economic, and social changes) is an important life social stressor that can have the same effect on risk of heart attack as smoking and hypertension. That is an important discovery and one that should influence our approach to managing health risks. Social stressors may be as important as physical ones.

But the takeaway should not be to avoid divorce at all costs. Here’s the counterpoint: being in an unhappy marriage is stressful and may be bad for your health. Why someone got divorced is an essential part of this conversation. The stress from marital discord can have a significant impact on one’s health, influencing everything from heart health to wound healing. Most marriages fall apart for a reason — they were incompatible, they grew apart, someone cheated, money was tight. It may not be the divorce itself that increases risk but rather the stress of the marriage leading up to it. Some people may better off divorced, statistics be damned. These results apply to a larger population, not necessarily each individual. Divorce may actually be protective for some men and women.

Heart health should probably not be the deciding factor in whether you should continue your marriage, but understanding how your life decisions impact your well being is critical to your health. Heart disease is the number one cause of death in United States and nearly one million adults will suffer a heart attack this year. These findings suggest that doctors, counselors, and patients should consider major life changes and stress like divorce as major contributors to an increased heart attack risk. (Oh, and know the signs and symptoms of a heart attack for men and women — quick treatment saves lives.)

It bears mentioning that participants in this study were all born between 1931 and 1953. Critical differences between the men and women selected, including their insurance and employment status and their overall health, may be completely different in later generations. It is unclear if we can apply these results to today’s future divorcées. I’m also curious how all of this stacks up to the risks found in the unmarried adults left out of the study. Are you better off single, married, divorced, or remarried? Inquiring minds want to know.

Image via Shutterstock.


Caroline Weinberg is a doctor with a masters in public health. She has previously written about science and health at Eater, Vice Motherboard, and a few dry academic publications. You can find her on twitter @ckw583.