“Your Weekly Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive.
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Are you married? Happily? My wife and I have been married 57 years—happily, though we sometimes have our disagreements. (She calls them discussions. I call them fights. She likes them. I don’t.)
According to a recent study of more than 6,000 individuals undergoing heart catheterization for known or suspected coronary (cholesterol-related) artery disease and followed for almost four years, the chances of living longer were greater if they were married.
Unmarried individuals—whether divorced, separated, widowed, or never married—have about a 50% higher rate of cardiovascular death or heart attack compared to married folks. In other heart studies, unmarried people undergoing coronary bypass surgery or stent placement had higher adverse cardiovascular events compared to married people. But you need a happy marriage because unhappy marriages had poorer outcomes compared to happy ones.
What might explain these findings? A host of possibilities exist: unmarried people may experience a lack of social support, lack of caregiving, and emotional or financial stress and a more sedentary lifestyle. Unmarried individuals may have also self-selected because of psychological or socioeconomic problems. Married couples may have better adherence to medical advice and taking medications. Loneliness, which I addressed in a previous column, can play a role. Blood pressure may be important since high marital quality has been shown to be associated with lower blood pressure, lower stress, less depression, better sleep patterns, and greater satisfaction with life.
Note the emphasis on “high marital quality.” Unmarried individuals compared with those in low-quality marriages had lower blood pressure, suggesting that single individuals fare better than their unhappily married counterparts. Happily married couples have reduced inflammatory markers in the blood, reduced neural stress on the heart, and better functioning immune systems, all of which can impact the development of coronary artery disease. The link between marriage quality and cardiovascular risk appears to be greater in older individuals and more pronounced among women than men.
Whatever the reasons—and they are many and complex—marital status and marital quality are consistent predictors of health outcomes, including cardiovascular disease and mortality. What can you do about it? Obviously, be happily married—not so easy for many people. But at least be aware of the fact that being unmarried or unhappily married can detrimentally affect your general and cardiovascular health. Forewarned is forearmed. Try to change that, if you can.
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