The more wives a man has, the greater his risk of heart disease, the first major study of the health risks of polygamy finds. A new study conducted in Saudi Arabia and UAE has found that polygamy can increase the risk of heart disease by more than four-fold in men.
The prospective multicentre observational study examined the relationship between the presence and severity of coronary artery disease (CAD) and number of wives.
"Men who practice polygamy have up to four concurrent wives who can reside in the same or different regions but do not normally reside in the same house," said Dr Amin Daoulah, a cardiologist at the King Faisal Specialist Hospital and Research Centre in Jeddah, Saudi Arabia.
The study included patients referred for coronary angiography at 5 hospitals in Saudi Arabia and the United Arab Emirates.
CAD was defined as more than 70% narrowing in a major epicardial blood vessel or more than 50% in the left main artery (called left main disease, LMD). Multivessel disease (MVD) was defined as more than one diseased vessel. The 687 married men in the study had an average age of 59 years and 56% had diabetes, 57% had hypertension and 45% had a past history of CAD.
Around two-thirds of the men had one wife (68%) while 19% had 2 wives, 10% had 3 wives and 3% had 4 wives.
Men with more than one wife were more likely to be older, live in a rural area, have a higher income and 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," said Daoulah.
"Also, in the regions that we studied, 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 travelling daily to urban areas for higher paid work," said Daoulah.
The researchers found a significant association between number of wives and the presence of CAD, LMD and MVD. Risk increased with the number of wives.
After adjusting for baseline differences, the researchers showed that men who practiced polygamy had 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.
"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," Daoulah said.
"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," Daoulah said.
The study was presented at the Asian Pacific Society of Cardiology Congress 2015 in Abu Dhabi.