New research presented at the Asian Pacific Society of Cardiology Congress 2015 reports an association between polygamy and increased heart disease risk, with the level of risk and severity of heart disease increasing with the number of wives.
The study can only report an association between polygamy and heart disease, and not that polygamy causes heart disease.
The authors behind the new study say there is evidence that married people have better overall health and longevity but that until now there have been no studies looking at the effect of polygamy on cardiovascular health.
Practiced mainly in North and West Africa, the Middle East, Central Asia and Southeast Asia, men practicing polygamy have up to four wives, although they do not normally all live together in the same house.
The multicenter observational study was conducted by cardiologists across five hospitals in Saudi Arabia and the United Arab Emirates. The participants in the study were 687 married men with an average age of 59.
Fifty-six percent of the men had diabetes, 57% had hypertension and 45% had a prior history of coronary artery disease (CAD). Sixty-eight percent of the men had one wife, 19% had two wives, 10% had three wives and 3% had four wives. Men with multiple wives were more likely to be older, live in a rural area, have a higher income and also have a history of coronary artery bypass grafting (CABG).
“Polygamy may be more frequent in rural areas because it is more culturally acceptable and getting married at a young age is more common,” says study author Dr. Amin Daoulah, a cardiologist at the King Faisal Specialist Hospital and Research Centre in Jeddah, Saudi Arabia.
“Also, in the regions that we studied,” he continues, “there was a higher percentage of national citizens residing in rural areas compared to urban areas. Men with multiple wives have to be well supported financially, and although Saudis and Emirati people are supported by their governments, polygamists may need more than one income. They may therefore take on extra employment or have the added pressure of traveling daily to urban areas for higher paid work.”
‘Significant association’ between number of wives and heart disease
In the study, there was a significant association between number of wives and symptoms of CAD, disease of the left main artery (LMD) and disease of multiple blood vessels (MVD).
Overall, the men who practiced polygamy were found to have a 4.6-fold increased risk of CAD, a 3.5-fold increased risk of LMD and a 2.6-fold elevated risk of MVD.
Dr. Daoulah hypothesizes on what is driving the association between heart disease and having multiple wives:
“We found an association between an increasing number of wives and the severity and number of coronary blockages. This could be because the need to provide and maintain separate households multiplies the financial burden and emotional expense. Each household must be treated fairly and equally, and it seems likely that the stress of doing that for several spouses and possibly several families of children is considerable.”
However, the study did not closely analyze confounding factors such as physical activity, level of intimacy, dietary habits and what effects interbreeding with close relatives may have, genetically.
Therefore, the study can only report an association between polygamy and heart disease, and not that polygamy causes heart disease. Dr. Daoulah says that further studies are needed to verify this association.
“We know that long-term stress in family life increases the risk of coronary heart disease (CHD) and it would be interesting to see what effect polygamy had on wives’ CHD risk,” suggests Prof. Michel Komajda, course director of the European Society of Cardiology program in Abu Dhabi.
“People with psychosocial risk factors are less likely to take cardiac medications, which could be relevant in the group with prior CABG. Extra support may be needed to adhere to prescribed drugs and change lifestyle,” Prof. Komajda adds.