Happy marriage extends life in heart patients

Heart disease patients who are happily married may outlive their peers who are in more rocky relationships, researchers report.

Their study found that happily married male and female patients with congestive heart failure were more likely to be alive after four years than patients in more contentious partnerships, regardless of the severity of the illness. In fact, a good marriage had a similar effect on survival to less severe heart disease, according to the report in the September 1st issue of the American Journal of Cardiology.

It is not clear how the quality of a patient’s marriage influences survival, but the investigators, led by Dr James C Coyne of the University of Pennsylvania in Philadelphia, suggest that a happy marriage may affect neurological or hormonal systems that influence the course of the disease. Alternatively, a solid partnership may make it easier to commit to a strict diet, exercise and medication regimen.

“I think spouses contribute directly to keeping patients on track but are also of great assistance when patients’ morale or commitment to their health flags,” Coyne told Reuters Health. “If everything else fails, the spouse in a good marriage can insist: “please do this for me.”

Coyne added that factors present in a bad marriage such as nagging, criticism and conflict could take a toll on a patient’s health.

“A patient who is otherwise having a hard time sticking to restrictions can get even more stubborn and self-destructive,” he explained.

According to the study, a solid partnership may be even more important for female patients. Coyne noted that women may be more sensitive than men to the support they are getting in their marriages.

The findings support a growing body of evidence linking social support with better health outcomes, including prolonged survival among patients with heart disease in general.

In the current study, the investigators interviewed 189 patients — including 139 men — and their spouses. Couples were asked to identify a topic of disagreement in their relationship and were then interviewed separately. Researchers videotaped couples as they discussed the area in which they disagreed and then rated the tapes according to how well the couples worked together and how positive their behaviour was. Couples were followed for the next four years.

“How well a couple is working together predicts which patients with chronic heart failure will be alive in four years,” Coyne told Reuters Health. “Cardiologists need to pay attention to interpersonal factors.”