The Effect of Divorce on Cardiac Autonomic Functions inWomen: Relationship Between Hamilton Anxiety Score and Heart Rate Variability

Objective: The aim of this study was to evaluate the effects of divorce on cardiac autonomic functions by measuring heart rate variability (HRV) in women. Material and Methods: The study group consisted of 150 women who had been divorced in the past 12 months and the control group consisted of 50 age-matched married women. Level of anxiety was assessed using Hamilton Anxiety Rating scale (HAM-A). Correlations between level of anxiety and HRV parameters were analyzed. Result: SDNN, SDANN index and SDNN index were significantly lower in the study group compared to the control group (129.8±31.8 vs 143.4±41.5 p=0.01, 119.0±30.6 vs 130.4±38.3 p=0.03 and 54.1±14.8 vs 59.9±18.0 p=0.02, respectively). rMSSD and pNN50 decreased in study group but not to a statistically significant degree (31.6±12.3 vs 35.8±17.7 p=0.06 and 11.0±8.0 vs 13.7±12.2 p=0.08, respectively). In study group, LF power and LF/HF ratio were significantly higher than those in control group (974.4±407.7 vs 822.1±429.4 p=0.03 and 4.14±4.54 vs 2.86±1.87 p=0.05, respectively). HAM-A score was negatively correlated with SDNN, SDANN, SDNN index, RMSSD, pNN50, HF power and positively correlated with LF power and LF/HF ratio. Nighttime SDNN and RMSSD were significantly lower in divorced women than those in married women (p=0.023 and p=0.046, respectively). According to multivariate logistic regression analysis, following factors were related to divorce: smoking, HAM-A score, SDANN and LF. Conclusion: Divorce has an unfavorable effect on cardiac autonomic functions. Cardiac autonomic dysfunction appear to parallel the level of anxiety. Divorce can increase cardiovascular disease risk in women.