Bad marriage, broken heart?

The findings suggest the need for marriage counseling and programs aimed at promoting marital quality and well-being for couples into their 70s and 80s, said lead investigator Hui Liu, a Michigan State University sociologist.

"Marriage counseling is focused largely on younger couples," said Liu, associate professor of sociology. "But these results show that marital quality is just as important at older ages, even when the couple has been married 40 or 50 years."

The study, funded by the National Institute of Aging, an arm of the National Institutes of Health, is published online in the Journal of Health and Social Behavior.

Liu analyzed five years of data from about 1,200 married men and women who participated the National Social Life, Health and Aging Project. Respondents were aged 57-85 at the beginning of the study.

The project included survey questions about marital quality, and lab tests and self-reported measures of cardiovascular health such as heart attacks, strokes, hypertension and high levels of C-reactive protein in the blood.

Liu set out to learn how marital quality is related to risk of heart disease over time, and whether this relationship varies by gender and/or age. Among her findings:

• Negative martial quality (e.g., spouse criticizes, spouse is demanding) has a bigger effect on heart health than positive marital quality (e.g., spousal support). In other words, a bad marriage is more harmful to your heart health than a good marriage is beneficial.
• The effect of marital quality on cardiovascular risk becomes much stronger at older ages. Over time, the stress from a bad marriage may stimulate more, and more intense, cardiovascular responses because of the declining immune function and increasing frailty that typically develop in old age, Liu said.
• Marital quality has a bigger effect on women's heart health than it does on men's, possibly because women tend to internalize negative feelings and thus are more likely to feel depressed and develop cardiovascular problems, Liu said.
• Heart disease leads to a decline in marital quality for women, but not for men. This is consistent with the longstanding observation that wives are more likely to provide support and care to sick husbands, while husbands are less likely to take care of sick wives. "In this way, a wife's poor health may affect how she assesses her marital quality, but a husband's poor health doesn't hurt his view of marriage," Liu said.