If you practice polygamy and have multiple wives, your chances of developing heart disease is 4 times higher than others.

According to Dr Daoulah, until now no study had assessed the effect of polygamy on cardiovascular health. 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. Polygamy is practiced mainly in North and West Africa, the Middle East, Central Asia and Southeast Asia.

The prospective multicentre observational study examined the relationship between the presence and severity of coronary artery disease (CAD) and number of wives. It included consecutive patients referred for coronary angiography at 5 hospitals in Saudi Arabia and the United Arab Emirates.

The 687 married men in the study had an average age of 59 years and 56 percent had diabetes, 57 percent had hypertension and 45 percent had a past history of CAD. Around two-thirds of the men had one wife (68 percent) while 19 percent had 2 wives, 10 percent had 3 wives and 3 percent had 4 wives. There were significant baseline differences according to the number of wives. Men with more than 1 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).

Dr Daoulah said that 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.

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.

Dr Daoulah explained that the reason could be the need to provide and maintain separate households multiplies the financial burden and emotional expense.

However, he added that unmeasured confounding variables such as physical activity, level of intimacy, dietary habits and genetic effects from interbreeding with close relatives needs to be analyzed in greater depth as they may influence the outcome. In conclusion, the problem of coronary heart disease and polygamy was only an association and not necessarily a root cause therefore further studies were required to verify the link.