People who survive a heart attack have a higher risk of suffering a second attack if they are divorced or have low socioeconomic status, the results of a new study suggest.

While low socioeconomic status has previously been linked with suffering a first heart attack, little was known about the risk of a second attack, so Swedish researchers decided to look into this further.

They monitored over 29,000 survivors of a first heart attack for an average of four years. The participants' socioeconomic status (disposable household income and education level) was assessed, as was their marital status.

The study found that socioeconomic status and divorce were significantly linked with a higher risk of a second heart attack.

Overall, divorced participants had an 18% increased risk of suffering a second heart attack compared to married participants.

When it came to socioeconomic status, those with the highest household income had a 35% lower risk of suffering a second heart attack than those with the lowest income.

And those with 12 years of education had a 14% lower risk than those with nine or fewer years of education.

While the study also found that unmarried and widowed participants had a higher risk of a second attack, the link was not found to be significant.

"Marriage appears to be protective against recurrent events and aligns with traditional indicators of higher socioeconomic status, but conclusions on the underlying mechanisms cannot be drawn from this study.

"The take-home message is that socioeconomic status is associated with recurrent events. No matter the reasons why, doctors should include marital and socioeconomic status when assessing a heart attack survivor's risk of a recurrent event. More intense treatment could then be targeted to high-risk groups," commented the study's author, Dr Joel Ohm, of the Karolinska Institutet.

Details of these findings are published in the European Journal of Preventive Cardiology.