The Connection Between a Healthy Marriage and a Healthy Heart

A recent study suggests that men in marriages that improved over time may have a lower risk for heart disease.

A newly married couple hold hands, closeup is on the hands.

For many, marriage signals the beginning of an entwined and, at times, tangled relationship. Spouses often play the role of friend, co-parent, caregiver, financial partner and emotional support system for their significant other. Given the amount of time spouses spend together, it makes sense that the quality of your marriage would correlate with your physical health.  

Recently, a study in the Journal of Epidemiology and Community Health followed 620 married fathers in the U.K. and found that those who reported that their marriages flourished over time also experienced improvements in several cardiovascular disease risk factors, including cholesterol and body mass index (BMI), compared with those who reported being in consistently happy or unhappy marriages. Those whose relationships deteriorated over time found a worsening in some of those same risk factors, including blood pressure.

While this is the first study to look at the effects of marital health on cardiovascular measures over an extended period of time, it’s not the first study to look at the relationship between marriage and heart health (or health in general). In 2011 the journal Demography published a study that followed men and women aged 25 years and older from the mid-1980s to the end of the 1990s. The researchers found that those who were married, especially men, tended to live longer than those who were not married. In 2014, a study published in Psychological Bulletin analyzed 126 published research papers over the past 50 years that looked at the association between marriage quality and physical health in more than 72,000 people. The researchers found that happier marriages were related to better health outcomes, including fewer hospitalizations, fewer severe diseases and less physical pain. “The results of the new study are not surprising given the rich literature on how social support helps with cardiac issues,” says Matthew Burg, PhD, a clinical psychologist and professor of cardiovascular medicine at the Yale School of Medicine who studies how stress and emotional factors affect cardiovascular disease.

Indeed, studies have shown that couples in happy marriages were more likely to help a partner start and maintain a new healthy habit. On the other hand, people who experienced “social rejection,” which is characterized by feeling unwanted or estranged from someone you have a close relationship with, also showed greater levels of pro-inflammatory cytokines, which are proteins that trigger inflammation in the body as part of the immune system response. High levels of inflammation for long periods of time can lead to arthritis, diabetes, and cardiovascular disease.

Of course, the science of social support is a complex one and researchers have a lot of work to do to refine the data they collect in order to draw any meaningful conclusions, says Dr. Burg. “It's likely that the type of support I need and am getting varies depending on where I am in my life, my age and my socioeconomic standing,” he says. “When is emotional support most important? When is tangible support most important?”

For over a decade, Dr. Burg ran one of several studies in a multi-center trial funded by the National Heart, Lung and Blood Institute to study heart attack patients and how their levels of “social support,” loosely defined as the feeling of being cared for and having people to rely on in times of need, affected how quickly they recovered. He and his colleagues found that those with low levels of social support and/or depression had the most difficulty bouncing back from a heart attack. In cases like these, the researchers found that group therapy made a significant difference.

For now, Dr. Burg and his colleagues are exploring ways to harness technologies that allow patients to track real-time data related to social support, conflict and markers of hypertension to better understand exactly what will help individual patients. The hope, he says, is to reach specific conclusions that lead to particular health benefits.

In the meantime, if your relationship needs a little TLC, remember that working on it may be good for your heart in more ways than one.    

To learn more about Yale Medicine’s programs for preventing, diagnosing, and treating heart disease, visit our Cardiology Department.