Broken Partnership and First Time Myocardial Infarction
Broken Partnership and First Time Myocardial Infarction
In men, a total of 22 406 337 person-years were observed, during which 56 216 incident cases of fatal or non-fatal MI occurred. In women, a total of 22 733 638 person-years were observed, during which 16 497 incident cases of fatal or non-fatal MI occurred.
Table 1 shows the number of MI cases and age-adjusted incidence rates according to time since broken partnership and socio-demographic variables for men and women. The age-adjusted incidence rates indicate that broken partnership and all covariates were associated with MI.
The result of the test for interaction between sex and time since broken partnership was P <0.0001, which indicated that the associations between time since broken partnership differ between men and women. Table 2 shows the IRR of MI, 95% CI and P-values in men and women adjusted for age and calendar year (model 1) and for all covariates (model 2). In the fully adjusted model compared with the reference group, the rate of MI in men with broken partnership in the same year was not increased when comparing with the consistently cohabiting IRR 0.97 (95% CI 0.90–1.05). In the year after broken partnership, men had an increased rate of MI with IRR 1.25 (95% CI 1.17–1.34). The higher rate of MI declined to a lower level during the following years but remained different from the continuously cohabiting [2–3 years after broken partnership, IRR was 1.12 (95% CI 1.06–1.18), 4–8 years IRR was 1.09 (95% CI 1.05–1.14) and 9 years or longer since broken partnership IRR was 1.09 (95% CI 1.05–1.12)]. In men, the CONTRAST test for the difference between same year as broken partnership and all following years was p = 0.0001. Further, we tested if the excess risk found 1 year after broken partnership differed from 2 or more years after broken partnership. The result of this test was p = 0.0009. In women, those who experienced broken partnership in the same calendar year had an increased rate of MI compared with those who consistently cohabited, with IRR 1.45 (95% CI 1.26–1.66). The following years, until 4–8 years, the higher rate of MI declined [1 year after broken partnership IRR 1.30 (95% CI 1.14–1.50), 2–3 years after broken partnership 1.26 (95% CI 1.13–1.39) and 4–8 years after broken partnership 1.17 (95% CI 1.08–1.26)]. After 9 years or longer since broken partnership. the IRR increased to 1.24 (95% CI 1.17–1.32). In women, the CONTRAST test for the difference between same year as broken partnership and all following years was p = 0.0229.
Table 3 shows IRR of MI and 95% CI in men and women stratified by age (30–49 years and 50–65 years). In the fully adjusted models, the pattern between broken partnerships and MI was similar in men regardless of age. In women, the pattern differed with age group. In women aged 49 years or younger, the largest IRR was found in the 1st year after BP (similar to men), whereas in women aged 50 years or older, the IRR was highest the same year as BP.
Results
In men, a total of 22 406 337 person-years were observed, during which 56 216 incident cases of fatal or non-fatal MI occurred. In women, a total of 22 733 638 person-years were observed, during which 16 497 incident cases of fatal or non-fatal MI occurred.
Table 1 shows the number of MI cases and age-adjusted incidence rates according to time since broken partnership and socio-demographic variables for men and women. The age-adjusted incidence rates indicate that broken partnership and all covariates were associated with MI.
The result of the test for interaction between sex and time since broken partnership was P <0.0001, which indicated that the associations between time since broken partnership differ between men and women. Table 2 shows the IRR of MI, 95% CI and P-values in men and women adjusted for age and calendar year (model 1) and for all covariates (model 2). In the fully adjusted model compared with the reference group, the rate of MI in men with broken partnership in the same year was not increased when comparing with the consistently cohabiting IRR 0.97 (95% CI 0.90–1.05). In the year after broken partnership, men had an increased rate of MI with IRR 1.25 (95% CI 1.17–1.34). The higher rate of MI declined to a lower level during the following years but remained different from the continuously cohabiting [2–3 years after broken partnership, IRR was 1.12 (95% CI 1.06–1.18), 4–8 years IRR was 1.09 (95% CI 1.05–1.14) and 9 years or longer since broken partnership IRR was 1.09 (95% CI 1.05–1.12)]. In men, the CONTRAST test for the difference between same year as broken partnership and all following years was p = 0.0001. Further, we tested if the excess risk found 1 year after broken partnership differed from 2 or more years after broken partnership. The result of this test was p = 0.0009. In women, those who experienced broken partnership in the same calendar year had an increased rate of MI compared with those who consistently cohabited, with IRR 1.45 (95% CI 1.26–1.66). The following years, until 4–8 years, the higher rate of MI declined [1 year after broken partnership IRR 1.30 (95% CI 1.14–1.50), 2–3 years after broken partnership 1.26 (95% CI 1.13–1.39) and 4–8 years after broken partnership 1.17 (95% CI 1.08–1.26)]. After 9 years or longer since broken partnership. the IRR increased to 1.24 (95% CI 1.17–1.32). In women, the CONTRAST test for the difference between same year as broken partnership and all following years was p = 0.0229.
Table 3 shows IRR of MI and 95% CI in men and women stratified by age (30–49 years and 50–65 years). In the fully adjusted models, the pattern between broken partnerships and MI was similar in men regardless of age. In women, the pattern differed with age group. In women aged 49 years or younger, the largest IRR was found in the 1st year after BP (similar to men), whereas in women aged 50 years or older, the IRR was highest the same year as BP.
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