Religious orthodoxy and myocardial infarction in Jerusalem--a case control study

We examined the hypothesis that the degree of religious orthodoxy is an independent risk factor for coronary heart disease incidence in a study of 454 men and 85 women who experienced a first myocardial infarction. They were compared with a control group of 295 men and 391 women. All were Jewish residents of Jerusalem. The degree of religious orthodoxy was ascertained by interview of participants. Among the cases, 51% of the men and 50% of the women defined themselves as secular compared with 21% and 16%, respectively, among the controls. In a multivariate logistic model (including terms for age, ethnicity, education, smoking, physical exercise, body mass index and religious orthodoxy), the coefficients for age and smoking were positive and statistically significant, and those for education negative and significant. The risk for European born subjects was greater than for the other ethnic origin groups (statistically significant only in men). Secular subjects had a significantly higher risk of myocardial infarction compared to orthodox subject (odds ratio of 4.2 (95% confidence interval 2.6-6.6) for men and 7.3 (95% confidence interval 2.3-23.0 for women). This relationship was independent of the other variables in the model. The relation persisted in a subsample of cases who were examined 2-3 months after the acute phase of the infarction upon controlling for plasma cholesterol, high density lipoprotein cholesterol and hypertension. This finding should be substantiated. It would appear important to identify the components of religiosity associated with reduced risk.