Happy Marriages Keep Blood Pressures Normotensive

By Charles Bankhead
PROVO, Utah, March 20 -- Happily married men and women are more likely to waltz through life hand-in-hand with normal blood pressures than are singles, investigators here found.
Those partners in happy marriages had significantly lower waking and 24-hour blood pressure compared with singles, even those with a network of social support, Julianne Holt-Lunstad, Ph.D., of Brigham Young University, and colleagues, reported in the April issue of Annals of Behavioral Medicine.
But unhappily married patients had higher blood pressure than either the happily married or socially supported singles.
"There seem to be some unique health benefits from marriage," said Dr. Holt-Lunstad. "It's not just being married that benefits health. What's really the most protective of health is having a happy marriage."
Epidemiologic studies have indicated that social relationships afford protection against disease and associated morbidity and mortality. Evidence also suggests that married adults have less morbidity and lower mortality compared with unmarried individuals, the authors noted. Moreover, married people reportedly have higher levels of life satisfaction and happiness and a lower risk of depression.
Most prior research focused on marital status and ignored the impact of the quality of relationships, the authors continued. Additionally, previous studies have evaluated health-related outcomes rather than the potential mechanisms by which social relationships influence health and disease.
Dr. Holt-Lunstad and colleagues examined the influence of social relationships on blood pressure in 204 patients who had been married an average of eight years and 99 singles, 89% of whom had never been married. About a third of the study population was hypertensive (systolic ≥120 mm Hg or diastolic ≥80 mm Hg).
Each participant completed a battery of tests to assess social and psychological status. Blood pressure was assessed by means of 24-hour ambulatory monitoring, which recorded 72 blood pressure values at random intervals.
The investigators evaluated 24-hour and waking blood pressure and nocturnal dipping in blood pressure values. The 24-hour and waking blood pressure values did not differ between married and unmarried individuals.
Both groups had dips in blood pressure at night, but the decline was greater in the married group (P<0.01 for systolic, P<0.05 for diastolic). After stratification by marital satisfaction scores, nocturnal dipping did not differ between married individuals with low satisfaction scores and single people.
The quality of marital relationships had a significant impact on blood pressure values. Both marital adjustment and marital satisfaction predicted 24-hour (P=0.02, P=0.005) and waking (P=0.03, P=0.006) systolic pressures. On average, married individuals with higher adjustment and satisfaction scores had a 4 mm Hg lower 24-hour systolic compared with single people.
"Overall, as marital adjustment and satisfaction increase, 24-hour and waking ambulatory systolic BP decrease," the authors said.
A comparison of single people and individuals with sub-median marital satisfaction scores showed that the single group had significantly lower 24-hour and waking systolic (P<0.001, P=0.001) and diastolic (P=0.01, P=0.002). In a separate analysis limited to individuals with the lowest marital satisfaction scores, significant differences persisted for systolic but not diastolic pressures.
The investigators also found that a strong network of social support had no effect on any blood pressure values of singles and unhappily married people.
"There does appear to be something unique about the spousal relationship, as other relationships did not compensate for the lack of a satisfying marriage," they said.
The authors acknowledged several potential limitations of the study: a homogeneous study population (mostly white and well educated), a single 24-hour blood pressure assessment, and exclusion of individuals with alternative lifestyles.
Dr. Holt-Lunstad reported no disclosures.
Primary source: Annals of Behavioral MedicineSource reference:Holt-Lunstad J, et al "Is there something unique about marriage? The relative impact of marital status, relationship quality, and network social support on ambulatory blood pressure and mental health." Ann Behav Med 2008; DOI: 10.1007/s12160-008-9018-y.