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By Theresa Tamkins

THURSDAY, March 5, 2009 (Health.com) — When a marriage is rocky, it can make both partners feel depressed. But only middle-aged women—not men—seem to have health problems associated with marital strife, such as high blood pressure, excess belly fat, and other factors that boost risks for heart attack and diabetes, according to a study being presented Thursday at the American Psychosomatic Society meeting in Chicago.

“I think we’ve got to get used to the fact that a toxic relationship is toxic to your whole health,” says cardiologist Nieca Goldberg, MD, medical director of New York University's Women’s Heart Program.

In the study, University of Utah researchers looked at 276 couples to see if depression was the real reason poor marriages have been found to be harmful to health. The couples were middle-aged or older Utah residents who were mostly married for a long time—on average more than 27 years; they ranged in age from 32 to 76.

The researchers found that bad relationships were bad for health—for women at least. Women in troubled relationships were more likely than other women to be depressed. Plus, they were more likely to have metabolic syndrome, a cluster of risk factors including elevated blood pressure, high triglycerides, low levels of HDL (good) cholesterol, abdominal obesity, and elevated blood sugar—all basically steps on the road to heart attack or diabetes.

“For husbands, we didn’t see, on its own, that negative marital stuff was related at all to metabolic syndrome. The only thing it was related to was their depressive symptoms,” says Nancy Henry, a doctoral candidate in clinical psychology at the University of Utah. “For men, having a problematic marriage is still emotionally, but not physically, problematic healthwise.”

Although the researchers didn’t specifically ask the subjects about religion, many Utah residents are Mormons, who may be less likely than people in other religious groups to get divorced, says Henry. “Because we have this really traditional value of marriages here in this state, in this area, then I think we have surveyed couples that are staying together no matter what,” she says.

Next page: Why getting a divorce won't solve the problem

The researchers analyzed several aspects of the participants’ relationships—looking at levels of conflict, disagreement, and hostility. They found that 27 percent of the wives and 22 percent of the husbands were unsatisfied with their marriages, says Henry, who is also a psychology intern at the Salt Lake City VA Medical Center.

The study does not imply that getting a divorce would necessarily improve a woman’s health, says Henry. “We can’t really say ‘Dump your spouse, and you’ll be fine,’ ” she says. “There are a lot of other factors that go into this. Health habits over a number of years, personality factors—[marital strife] is just a small part what might help contribute to some of these health outcomes.”

The bigger question is, according to Henry, “Do we want to treat [the women’s] high triglycerides or low HDL or blood pressure with some medication, or do we want to treat the whole person?”

Dr. Goldberg agrees. She says doctors should look at all aspects of a patient’s life when trying to help them overcome health problems. “As studies like this emerge, the medical community can no longer amputate the head from the rest of the body,” says Dr. Goldberg, who was not involved in the new research.

Next page: Why are anger and hostility harmful to health?

She adds that anger and hostility in a marriage can increase stress hormones, which are associated with insulin resistance, ultimately leading to higher blood sugar and greater risks of diabetes and heart disease. “There have been studies that show that if a marriage is stressful, not a good relationship, those women have higher rates of heart attack,” says Dr. Goldberg.

Other research has shown that women, in general, are more affected by relationship issues than men, says Henry. “Women seem to nurture relationships more than men do and attach significance to the emotions within relationships more than men do,” she says. “That’s not to say men don’t want relationships, because we know they do, but they just don’t take as much stock in relationships with respect to their self-image, their self-concept, and those kinds of things.”

Dr. Goldberg says there are number of things people can do if they are feeling the stress or strain of a marriage—or life itself. “The things that lead to emotional health and lower levels of heart disease are being in a supportive environment and learning how to delegate: you can’t have a to-do list with 20 things on it if you can only do five,” says Dr. Goldberg, who is the author of Dr. Nieca Goldberg’s Complete Guide to Women’s Health.

She also recommends getting exercise to reduce stress and seeking counseling, if you need it. “Talk to someone,” she says.


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