How does the couple relationship influence heart health?

Published in Blog by Andrew Balfour on November 24th 2022

We intuitively know that the quality of our relationships - in particular our romantic, intimate adult partnerships - are of intrinsic importance to our health and well-being. Indeed, research is increasingly showing that the quality of our relationships affects our physical health in numerous ways, significantly with regards to heart health.

A recent study published in October 2022 from the Yale School of Public Health in New Haven explored the impact romantic relationships have on cardiovascular disease and found that marital stress directly leads to worse recovery after a heart attack. The study compared recovery one year after a heart attack with self-reported marital stress using the Stockholm Marital Stress Scale.

The paper found that participants reporting severe marital stress were 67% more likely to report chest pains than people with mild or no marital stress, and that the likelihood of being readmitted to the hospital for any cause increased by almost 50% among those who reported severe marital stress (American Heart Association News, 2022).

The research team ranked the participants on their physical health, mental health and stress levels using a self-reported 12-point scale. The findings revealed that those suffering severe marital stress scored 1.6 points lower in physical health on average, 2.6 lower in mental health, and 5 points lower in overall quality of life (American Heart Association News, 2022).

This research confirms just how profoundly affairs of the heart effect heart health, and corroborates the findings of numerous studies which have linked marital and relationship dissatisfaction with the increased risk of cardiovascular disease. Previous studies have found that the quality of couple relationships directly influences the survival rates after bypass surgery, with married people being 2.5 times more likely to be alive 15 years after coronary artery bypass grafting (CABG) than those who are not married, and those in high satisfaction marriages being 3.2 times more likely to be alive 15 years after CABG, compared with those reporting low marital satisfaction (King, 2011).

Similarly, another study found that marriages characterized as supportive (positive) as compared to ambivalent (both positive and negative) are associated with lower ambulatory blood pressure and less calcification of the coronary arteries, both robust risk factors for cardiovascular disease (Wendy C, 2016).

A holistic approach

Due to the large body of research which indicates the significant influence couple relationships have on heart health, we echo the Yale School of Public Health’s call for a holistic care model, which incorporates psychosocial aspects in relation to recovery and treatment.

Dr Cenjing Zhu, the paper’s lead researcher, argued that “healthcare professionals need to be aware of personal factors that may contribute to cardiac recovery and focus on guiding patients to resources that help manage and reduce their stress level” (American Heart Association News, 2022). A holistic care model which goes beyond viewing heart disease as a one-organ illness but includes targeting patients’ marital issues, mental health, and personal circumstances, has the capability to greatly improve recovery chances.

This call for a holistic care model was echoed by Nieca Goldberg, Medical Director of the American Heart Association, who identified how “this study highlights the importance of evaluating the mental health of cardiac patients” (American Heart Association News, 2022) and that this research is consistent with previous studies which show the “burden of marital stress” directly impacts women’s physical health outcomes.

Tavistock Relationships believes in light of this growing body of evidence and with heart and circulatory diseases causing a quarter of all deaths in the UK (British Heart Foundation,2022), it is crucial for the NHS to adopt a wider holistic model of care which accounts for the couple relationship. Doing so has the potential to increase cardiovascular recovery rates and significantly improve the public health landscape.