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Job loss raises heart attack risk

20th November 2012

Researchers in the United States say that losing a job puts a person at greater risk of a heart attack, especially later in life.

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However, the risk of a heart attack fades the longer a person has been unemployed, disappearing altogether if joblessness lasts more than a year.

A string of job losses carried the highest risk of acute myocardial infarction, or heart attack, according to the study, which examined data linked to 13,000 participants in the US Health and Retirement Study.

The rate of heart attack was elevated by 35% in people looking unsuccessfully for work, even after adjustments were made for social status, smoking and drinking, medical conditions  and obesity, they found.

Matthew Dupre of Duke University and colleagues found during the 20-year follow-up period of the study, that the risk was even higher among people who had undergone several job losses in a row.

The incidence of heart attack among people who had sustained more than four periods of involuntary unemployment was 63% higher than among those who were continuously employed.

Dupre and colleagues said the results showed what a powerful effect a person's lifetime employment history and cumulative job losses could have on risks for a major cardiovascular event.

Writing in the online version of the Archives of Internal Medicine, Dupre and colleagues argued that the findings have implications for healthcare provision, even though people can rarely change their risk of losing their jobs.

Individuals at elevated risk of a heart attack could be identified by medical staff through data about their employment status, number of job losses and the amount of time they had been unemployed.

But they said further studies would be needed to work out how such information could be used to help vulnerable people in practice.

The study relied on data from 13,451 participants in the Health and Retirement Study, which began in 1992 with 9,824 individuals aged 51 to 61, and recruited further participants later on.

All participants were interviewed every two years.

Of Dupre's group, 1,061 reported suffering heart attacks during the follow-up period, which appeared to yield an increased risk of 74% among the unemployed.

That fell to 35% once the results had been controlled for lifestyle, body mass index, high blood pressure, diabetes and depression.

However, they concluded that the risk to heart health from unemployment remained significant.

Retired study participants also showed a modestly increased risk of heart attack, compared with their employed counterparts.

The risk factor began to fall after people had been unemployed for more than a year, eventually falling back to the same level as those in employment after two years.

According to commentator William T. Gallo of City University of New York, the study further strengthens the link between unemployment and serious health problems.

He wrote in the same journal that the current study should be the last to do this, as evidence was now "compelling", calling for a move to studies that examine the effect of economic factors on patients' health, which are currently sorely lacking in medical literature.

Dupre's study was unable to examine the effects of different sorts of work, or the reasons for job loss.

It was also limited by a lack of information on the use of medication taken by participants for cardiovascular risk factors like high blood pressure, diabetes and high cholesterol.

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