If you are in a close relationship which has negative aspects, such as conflict, you may well have a raised risk of heart disease, compared to somebody whose close relationship has more positive aspects, says an article in Archives of Internal Medicine (JAMA/Archives), October 8th issue.

The authors explain “An extensive body of research shows that social relations are associated with better health and reduced risks of cardiovascular disease. However, contradictory findings on the health benefits of structural support and the limited protective effect of marital status against cardiovascular disease among women have stimulated further scientific inquiry into the quality of social relationships.”

Roberto De Vogli, Ph.D., M.P.H., University College London, and team looked at 9,011 British public functionaries (civil servants) who filled in a questionnaire about negative aspects of their close relationships between the periods 1989-1990 and 1985-1988. The participants also explained how much emotional and practical support they got from that person on a regular basis. They were followed up twelve years later to find out whether they had had a fatal or non-fatal coronary event – this included chest pain or a heart attack.

Of 8,499 people who were followed up and had provided enough information at the start of the study, 589 had had a coronary heart disease event – none of them had coronary heart disease at the beginning of the study. After making adjustments for such factors as sociodemographic characteristics and health habits, the researchers found that there was a 1.34 higher risk of coronary heart disease events among those who experienced a high level of negativity in their close relationships, compared to those who experienced low levels of negative close relationships.

Even after adjusting for depression and negative personality traits the researchers still found a small, but significant link.

The authors wrote “When one considers emotional factors and their biological translation into the body, research shows that negative marital interactions are associated with depression, often in combination with reduced self-esteem and/or higher levels of anger. These emotional reactions have been found to influence coronary heart disease through the cumulative ‘wear and tear’ on organs and tissues caused by the alterations of autonomic (involuntary) functions, neuroendocrine changes, disturbances in coagulation [blood clotting] and inflammatory and immune responses.”

The scientists also report that the link did not change according to sex or social position.

“It is possible that negative aspects of close relationships are more important for the health of individuals because of the power of negative close relationships to activate stronger emotions (worrying and anxiety) and the consequent physiological effects. In contrast, other more positive forms of support may not affect the physiology of individuals in a measurable or clinically relevant way,” they concluded.

Arch Intern Med. 2007;167(18):1951-1957
http://archinte.ama-assn.org

Written by: Christian Nordqvist