A new study by researchers in the US found that marital strain is more likely to affect women’s health than men’s, putting them a higher risk of stroke and heart disease due to depression, high blood pressure, obesity and other symptoms of metabolic syndrome.
The findings are being presented today, Thursday 5 March, at the American Psychosomatic Society’s annual meeting in Chicago, by first author, Nancy Henry, a doctoral student in psychology at the University of Utah in Salt Lake City.
Henry and colleagues, all psychologists from the University of Utah, found that although men in strained marriages were also likely to feel depressed, unlike women they were not at increased risk of metabolic syndrome.
Metabolic syndrome comprises five symptoms: high blood pressure, obesity around the waist, high blood sugar, high blood fats and low levels of good cholesterol or HDL. A person with these symptoms is at much higher risk of becoming diabetic, developing heart disease or having a stroke than a person that does not have them.
Henry and colleagues did the study because they wanted to test the idea that being angry and having frequent arguments, experiencing more conflict and hostility with one’s spouse would be linked with higher levels of metabolic syndrome.
“We further anticipated that this relationship would be at least partly due to depressive symptoms,” she explained.
What they found was while this was true for the wives, it was not so for the husbands.
“The gender difference is important because heart disease is the number-one killer of women as well as men, and we are still learning a lot about how relationship factors and emotional distress are related to heart disease,” said Henry.
The study is part of a larger project headed by Tim Smith, co-author of this study and a professor at the University of Utah. He cautioned about how to interpret the findings, explaining the study was a “simple preliminary test of what might be unhealthy about relationships for women”.
Although we can safely say that addressing things like diet and exercise, it was a bit early to suggest that women should dump their husbands to reduce their risk of developing metabolic syndrome, said Smith.
The larger study has already established “that a history of divorce is associated with coronary disease”, said Smith who said that the overall aim was to verify whether improving marriage might improve health.
For the larger study, the researchers recruited 276 couples who had been married for an average of 20 years and were aged between 40 and 70 years.
The participants filled in several questionnaires, some of which were specific to the smaller study led by Henry. The questionnaires included 10 scales covering positive aspects of marriage quality (eg mutual support, emotional warmth, friendliness, confiding in each other), negative aspects of marriage quality (eg arguments, hostility, disagreements) and symptoms of depression (not necessarily full blown clinical depression).
The participants also underwent physical exams where blood pressure, waist measurement, good cholesterol, fasting glucose and blood fats were measured, from which the researchers could decide if they had metabolic syndrome. Any couples where one spouse already had cardiovascular disease was excluded.
According to Henry, the results showed that women who reported more marital strain were also more likely to report depressive symptoms.
And Smith said that:
“Women who reported more marital strain had more metabolic syndrome symptoms, and that association can be explained by the fact they also reported more depressive symptoms.”
The results also showed that:
“Men in bad marriages also reported more depression, but neither marital strain nor depression was related to their levels of metabolic syndrome,” added Smith.
Henry explained that previous research has already shown that women are “more sensitive and responsive to relationship problems than men”.
“The results of this study suggest those problems could harm their health,” she added, explaining that “improving aspects of intimate relationships might help your emotional and physical well-being”.
Smith said that if a person cares about their health and wants to reduce their risk of heart disease and stroke, which is important because these are leading killers for both men a women, then it is important to look at all the risk factors such as blood pressure, cholesterol and, in this case, emotional health and family life.
Some experts are doubtful about the clinical validity of metabolic syndrome, sometimes called syndrome X or insulin resistance syndrome. They said it is just a collection of five risk factors for heart disease, stroke and diabetes and don’t see why they should be grouped.
Henry said there is still controversy among medical researchers and clinicians about whether it should be defined as a syndrome, “what should be included, how the different factors should be measured, whether all the factors hang together as a distinct syndrome or are they just separate things”.
She said studying the syndrome was a useful way to explain how “psychosocial risk factors” in marriage might be related to cardiovascular disease.
Smith added that:
“Strained marriages can increase your risk of heart disease, and that may in part be because strained marriages increase the risk of metabolic syndrome and thus heart disease.”
“The reason strained marriages might be related to metabolic syndrome is that strained marriages can be depressing, and depression is then the link to metabolic syndrome,” he explained.
The researchers speculated that the hormonal effects of the stress associated with depression could be why people deposit fat around the waist and why insulin resistance goes up, why blood fats go up and blood pressure rises. Thus this group of symptoms that results when the body responds to stress, is why the unifying notion of metabolic syndrome is appealing.
Sources: University of Utah News Center.
Written by: Catharine Paddock, PhD