In sickness and in health: relationship quality and cardiovascular risk and management
Heather E Tulloch1, Paul S Greenman2,3,4
1Division of Prevention and Rehabilitation, University of Ottawa Heart Institute.
Insights
Relationship quality significantly impacts cardiovascular health through direct and indirect pathways. Couple-based interventions focusing on relationship quality are crucial for improving heart health outcomes.
Area of Science:
- Cardiology
- Psychology
- Public Health
Background:
- Couple relationship quality is a significant predictor of long-term health.
- Chronic relationship conflict negatively impacts cardiovascular health.
- Relationship quality influences cardiovascular, neuroendocrine, and immune functions.
Purpose of the Study:
- To review the link between couple relationships and cardiovascular health.
- To explore mechanisms by which relationship quality affects heart health.
- To overview couple-based interventions for cardiovascular health.
Main Methods:
- Literature review of studies on couple relationships and cardiovascular health.
- Analysis of direct and indirect pathways of influence.
- Overview of existing couple-based cardiovascular interventions.
Main Results:
- Relationship quality affects cardiovascular health via direct (physiological) and indirect (lifestyle, adherence) pathways.
- Interventions targeting traditional cardiovascular risk factors show limited success.
- Few interventions focus on improving relationship quality for cardiovascular health.
Conclusions:
- There is a significant oversight in addressing relationship quality in cardiovascular health interventions.
- Attachment-based interventions, like Healing Hearts Together, show promise.
- Further research with large trials is needed to assess the impact of couple-based interventions on cardiovascular outcomes.
Purpose Of Review:
To review the link between couple relationships and cardiovascular health, the plausible mechanisms by which relationship quality affects heart health, and to provide an overview of couple-based interventions aimed at improving cardiovascular health.
Recent Findings:
Marriage and the quality of the couple relationship bond are robust predictors of long-term health outcomes. Chronic relationship conflict and disconnection can be deadly. There are direct and indirect pathways by which couple relationship quality affect cardiovascular health. Direct pathways include effects of relationship quality on cardiovascular, neuroendocrine, and immune functioning. Indirect pathways include effects of emotional, cognitive and behavioural factors that impact lifestyle choices and adherence to treatment regimens. Effects of couple-based interventions addressing traditional cardiovascular risk factors have been null to modest and there is only one couple-based intervention that addressed relationship quality and heart health. On the basis of the literature, this is major oversight. We propose attachment-based interventions, such as our Healing Hearts Together program, for patients with heart disease and their partners.
Summary:
Previous research indicates that couple-based interventions are promising. Large randomized controlled trials that aim to improve relationship quality among patients with CVD and their partners, as well as study mechanistic, surrogate, and clinical outcomes, are required to appropriately assess their impact.
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