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Losing your job increases heart attack risk

Losing your job can give you a heart attack – quite literally.

Duke University researchers have found that unemployment significantly raises the risk of a heart attack. And that risk goes up with each job loss and with increasing time spent unemployed, according to a study published in the Archives of Internal Medicine.

In fact, one job loss raised the risk of a heart attack by 35 percent, while four job losses raised the risk by 63 percent. The unemployed were at greatest risk of a heart attack within the year following a layoff or firing.

“Looking at a lifetime of exposure to a social stressor such as unemployment – the number of times a person has lost a job or the amount of time they’re without a job – there’s an independent association with heart attacks,” says the study’s lead author Matthew E. Dupre, an assistant professor of at Duke and a senior fellow at the university’s Center for the Study of Aging.

Dupre says he and his colleagues were somewhat surprised by their results, since they took into account known  and suspected risk factors, like high blood pressure and loss of health insurance.

“The fact that the associations remained largely unchanged despite accounting for more than a dozen suspected risk factors was somewhat unexpected,” he says. “Changes in income, health insurance, health behaviors, physical health status, and the like had little impact on the risks related to unemployment. Instead, we found that the risks associated with multiple job losses were of the magnitude of other established risk factors, such as smoking, hypertension, and diabetes.”

For the new study, the researchers scrutinized the health and work histories of 13,451 adults aged 51 to 64. Detailed histories covered a full 18 years, during which study volunteers suffered a total of 1061 heart attacks.

At the outset, 14 percent of the volunteers were unemployed. During the course of the study 69.7 percent lost one or more jobs.

Heart experts said that the study adds to the mounting evidence that certain kinds of stressors can ramp up the risk of a cardiovascular event.

“This is adding to what we know with regards to the triggers of cardiovascular events,” says Dr. John Schindler, an assistant professor of medicine at the University of Pittsburgh Medical Center. “Many years ago we thought of this as a random process. Now we see there are real triggers, whether environmental or perceived stress.”

Recent studies have turned up numerous emotional triggers, including frustration, depression, and anxiety, Schindler says. “And all of those go along with unemployment,” he adds.

So, what is it about job loss that might raise the risk of a heart attack?

“There are likely multiple mechanisms which link significant socioeconomic stress, including becoming unemployed, to an increased risk of cardiovascular events,” says Dr. Eliot Corday Professor of Cardiovascular Medicine and Science at the University of California, Los Angeles, Eliot Corday Professor of Cardiovascular Medicine and Science at the University of California, Los Angeles, and co-director of the UCLA preventive cardiology program. “These include sustained activation of the part of the nervous system involved with stress and stress-related hormones, decrements in heart healthy behaviors, avoiding preventive health visits and measures, and not seeking prompt medical attention when there are early warning signs.”

What the study shows, experts say, is that you need to pay extra attention to your heart in times of stress, such as job loss.

“My conclusion is that we should always be focused on our hearts since cardiovascular disease is potentially such a potentially deadly disease,” Schindler says. “But since we’re at greater risk the first year we lose a job, at that time we should be even more diligent about cardiovascular health.”

Future research could examine whether emotional support could help reduce risk.

“Whether the cardiovascular risk related to unemployment and multiple job losses could also be reduced by psychological support or enhanced social resources will require further study,” Fonarow says.

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