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Mend Your Marriage, Protect Your Heart

A bad relationship can hurt your circulatory system, so here's some advice

By Judith Graham

Couples grappling with less-than-satisfying relationships take note: new research confirms that difficult marriages can be harmful to your health.

Specifically, irritating interactions, unwelcome criticism, unhappiness, poor communication and emotional distance can pose a threat to your cardiovascular system, according to a study published late last year in the Journal of Health and Social Behavior

Women are more susceptible to these problems than men, the study found, and people between the ages of 75 and 85 are especially vulnerable.

The new report adds to a large body of research highlighting the impact of marriage on late-life couples. It’s been known for decades that individuals who are married tend to have better health; newer studies have demonstrated that the quality of marriages is what really makes a difference.

(MORE: 3 Surprising Secrets to a Long Marriage)

“It is not the case that any marriage is better than none,” researchers observed in the recent study. While good quality marriages provide a “safe haven from stress” for older couples, said Linda Waite, a co-author and a sociology professor at the University of Chicago, poor quality marriages can enhance stress, wreaking havoc on the heart and the circulatory system.

An Unusually Comprehensive Study

The new study is the first to examine marital quality over time in a large, nationally representative sample of older adults in the United States. Data comes from the National Social Life, Health and Aging Project, led by social scientists at the University of Chicago and funded by the National Institute on Aging. 

(MORE: Hope Springs Eternal for Boomers and Marriage)

In 2005-2006 and then again in 2010-2011, researchers asked 1,198 people who were married throughout the period a set of nine questions. How close was their relationship with their spouse? How happy was the marriage? How emotionally satisfying? Did spouses choose to spend free time together or apart? Did they open up to each other? Could they rely on one another? Did a spouse make too many demands? Criticize often? Get on your nerves?

Next, researchers linked answers to information about people’s health (Did they have high blood pressure? An accelerated heart rate? Markers of systemic inflammation? Had they suffered a heart attack, heart failure or stroke?) and discovered notable gender and age-related differences:

Women who experienced an increase in marital strain over this five-year period had a higher risk of hypertension and inflammation. The same was not true for men.

From an evolutionary perspective, “women are more dependent on the men they’re mated with” for protection and sustenance during years of pregnancy and childrearing, Waite said.

From a social perspective, women are taught to be more relationship-focused, said Kira Birditt, a research associate professor at the University of Michigan’s Institute for Social Research. “The finding that older women are more affected by negative marital quality than older men is fascinating,” she said.

The quality of couples’ marriages became more important as they moved into older age, especially for women.

In part, this may reflect the cumulative impact of stress, which constricts blood vessels, raises blood pressure, elevates heart rate and fosters heightened levels of inflammation. These effects typically take years to become manifest and become most evident with advancing age, the study noted. 

Also, in part, this may reflect emotional challenges associated with aging (adjusting to retirement, the loss of friends and family, a shift in social roles) as well as physical challenges (declining immune function, increasing frailty and ongoing wear and tear on physiologic systems).

“Older adults experience a shift in priorities and desire closer, more meaningful ties as they age, so it makes sense that people find marital conflict even more distressing when they’re older,” Birditt said.

Improving Marriages Is Eminently Possible

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Is change possible, even when couples have been together for 30, 40, 50 years or even longer?

“Absolutely, as long as there is a commitment and willingness to work on issues,” said Paula Hartman-Stein, a geropsychologist at the Center for Healthy Aging in Kent, Ohio. 

She tells of helping an elderly couple — he was 91, she was 85 — who had come in because the wife was worried about her husband’s memory and troubled by some of his behaviors. After tests showed that he had mild cognitive impairment but not dementia, Hartman-Stein worked with the couple on improving communication, having more fun and being more physically affectionate.

After only five sessions, the couple reported they were happier, kinder to each other and spending more time together, Hartman-Stein said. At that point, they had been married for 65 years.

Just as science has confirmed the ability of brains to change with new stimulus (“brain plasticity”) throughout life, the same is true of relationships, said Michele Weiner-Davis, author of Divorce Busting: A Step-by-Step Approach to Making Your Marriage Loving Again and a marriage therapist in Boulder, Colo. “We do not have to be pessimistic and think that our future is nothing more than an inevitable extension of the past,” she said.

(MORE: Love Advice That Shocked the Expert)

Outside of therapy, these are a few steps you can take to improve your marriage and your health:

Don’t wait for your spouse to act first. All it takes is one person behaving differently to trigger a change in a relationship, Weiner-Davis said.

Start with small changes. Even something that seems insignificant — for instance, remembering to ask “How are you?” in the morning — can quickly alter the tenor of interactions.

Focus on actions, not feelings. Think about when you and your spouse were getting along better. What did you enjoy doing? Try doing that even if you don’t feel like it. “Actions will produce positive feelings and a better response,” Weiner-Davis said.

Look for the positive. Pay attention to what’s right with the relationship, not what’s wrong, said Mona DeKoven Fishbane, author of Loving with the Brain in Mind: Neurobiology and Couple Therapy and director of the couples therapy training program at the Chicago Center for Family Health. Develop opportunities to express generosity and gratitude. “Happy couples create a culture of positivity,” she noted.

Practice, practice, practice. Try new ways of interacting with your partner and exercise those daily, Fishbane advised, adding, “that’s how we form new emotional habits” and resist the tendency to go on “automatic pilot” with our partners.

Be your best self. “Think about who you want to be in your relationship and reach for your best self,” Fishbane recommended. “Often, your partner will come back with their best self because they’re not being threatened by you any longer.”
 
Judith Graham is a freelance journalist who specializes in writing about aging and health.

Judith Graham is the Navigating Aging columnist for Kaiser Health News. Read More
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