Bad Marriages Exacerbate High Blood Pressure

"We've always known that social support moderates blood pressure and cardiovascular response, and this is direct evidence of that," said Dr. Brian Baker of the department of psychiatry and the University Health Network. In a study published in the December 11 issue of the Archives of Internal Medicine, Baker and his research team found new evidence to support the old adage that bad marriages are bad for your health. They examined the effects of positive and negative marital relationships on people with mild hypertension and found that unhappy marriages in fact do increase blood pressure.

At the beginning of the study more than 100 men and women completed a questionnaire to determine the quality of their marriages and wore monitors that repeatedly measured their blood pressure over a 24-hour period. Three years later, the participants had their blood pressure recorded again and kept diaries describing the amount of time they spent with their husbands or wives while they wore the monitor.

"If you had a bad marriage three years ago, three years later we found it was worse to be with your spouse because your blood pressure was raised compared to when you're not with them," Baker said. In good marriages, however, blood pressure went down when people were with their spouses. "It's the reverse finding. It's better to be with your spouse-it's protective." The results also showed that after three years people with low marital adjustment scores had a statistically significant thickening of the heart's left ventricle, an indication of high blood pressure.

Baker's interest in the impact of marriage on hypertension evolved from a longstanding curiosity about the way psychosocial factors can affect a person's illness, whether it is schizophrenia, depression or heart disease. Previous research has shown that job strain elevates blood pressure, and Baker hypothesized that a study on marital stress would yield similar results. "I thought, Why can't this model apply to marriage because marriage is a very difficult institution in the sense that there's lots of marital strife and marriages breaking down all over the place," he said.

Though it has yet to be confirmed by further studies, Baker does not believe that marital discord alone, or any other kind of chronic psychosocial stress, can actually cause high blood pressure in people who are not already predisposed to it. "I think you inherit a biological tendency, and that stress over time at work and at home can bring out what is already there."

He says any new findings on factors that aggravate hypertension are important because it is such a widespread and poorly understood condition. And the study, funded by the Heart and Stroke Foundation and the Canadian Institutes of Health Research, offers doctors a novel prescription for high blood pressure. "There's treatment for marital stress-the treatment is marital counselling," he said. "And this raises the unbelievable spectre for physicians of treating hypertension with marital counselling."