Preliminary research to be presented November 6 at the American Heart Association’s Scientific Sessions 2022 found that marital stress among younger adults — ages 18 to 55 — was linked to worse recovery after a heart attack. The study’s findings have not been published in a peer-reviewed journal. “Healthcare professionals need to be aware of personal factors that may contribute to cardiac recovery and focus on guiding patients to resources that help manage and reduce their stress levels,” said the study’s lead author Cenjing Zhu, a PhD candidate in the department of chronic disease epidemiology at the Yale School of Public Health in New Haven, Connecticut, in a press release.
Marital Strain Can Bring on Chest Pain and Other Symptoms
For their analysis, Zhu and her colleagues at Yale reviewed hospital data on 1,593 adults who were either married or in a committed partnership and treated for a heart attack at 103 U.S. hospitals in 30 states across the country between 2008 and 2012. One month after their heart attacks, participants completed a questionnaire called the Stockholm Marital Stress Scale, which assesses marital stressors, including quality of the emotional and sexual relationship with the spouse or partner. Answers sometimes reveal specific difficulties, such as infidelity, substance abuse, and money-related problems. Patients were then followed up to one year. Based on participants’ self-reported responses regarding stress as well as physical and mental health, Zhu and collaborators discovered that those who had reported severe marital stress were 67 percent more likely to experience chest pains than people with mild or no marital stress. Those who had severe marital stress had nearly a 50 percent greater chance of being readmitted to the hospital for any cause. The study also highlighted that individuals with high stress levels scored lower on assessment tests measuring physical health, mental health, and quality of life one year after a heart attack. Nieca Goldberg, MD, a clinical associate professor of medicine at NYU Grossman School of Medicine, who was not involved in the research, underscored that relationship issues are often not addressed when it comes to heart health. “It’s about time that we looked at the impact of the quality of a relationship and how it impacts cardiovascular health,” she says. “The healthcare system pretty much focuses more on physical health, and we need to look at this more as global health, incorporating both physical and mental health because they are dependent on each other.” When it comes to sex in particular, Dr. Goldberg noted that heart attack survivors can have many fears and concerns about how this will affect their health. She added that the investigation’s focus on people ages 18 to 55 recognizes that heart attacks among younger adults have been rising, as Brigham Health Hub also notes. A study published in 2018 in the American Heart Association journal Circulation showed that hospital admissions for heart attack among adults ages 35 to 54 steadily increased from 27 percent in 1995 to 1999 to 32 percent in 2010 to 2014. A study published in 2019 in the Journal of the American College of Cardiology validated the trend, confirming that more heart attacks are striking those under age 40. “Ultimately, we want everyone to prevent heart attacks, but we also want our messages about healthy hearts to get to younger people as well,” said Goldberg, who is also an expert volunteer with the American Heart Association.
Women Are More Likely to Experience Relationship Stress Than Men
Two-thirds of the study participants were women, and the average age of patients was 47 — about three-quarters were white, 13 percent were Black, and nearly 7 percent were Hispanic. Of this population, women were more likely to express they were experiencing significant strain from relationship issues. Almost 4 out of 10 women reported severe marital stress versus 3 out of 10 men. Goldberg pointed out that women are often the caregivers in the family — tending to children, preparing meals, and shopping. When there is a shift in who is taking care of such things in a relationship, that can cause strain. “Additional stressors beyond marital stress, such as financial strain or work stress, may also play a role in young adults’ recovery [from heart attack], and the interaction between these factors require further research,” said Zhu in the press release. According to Goldberg, if one partner has had a heart attack, they might be consumed by their health and that has an impact on their overall health, on the relationship, and on the overall health of the people in the relationship. “There has to be a greater emphasis on emotional stress and how that impacts physical health.”
