Marriage triples our bypass surgery survival rates – but only if it’s happy

by Carolyn Thomas      @HeartSisters

While the recent headlines about this new cardiac study suggest that a happy marriage can triple (and even quadruple!) your longterm survival chances after heart bypass surgery, there’s more behind this story than the wedded bliss angle.

Researchers from the University of Rochester tell us that happily married people who undergo coronary bypass surgery are three times more likely to be alive 15 years later compared to their unmarried counterparts. For happily married women, those odds can actually jump to four times higher.

But buried in the good news hype is another important fact: that for women who do not rate their marriage as happy, survival stats are virtually identical to those for unmarried women.  After 15 years of follow-up, researchers found that 83% of happily wedded wives were still alive after their cardiac bypass surgery, versus only 28% of women in unhappy marriages.

Dr. Kathleen King, lead author on the study published in Health Psychology, concluded that there’s something in a good relationship that helps these heart patients stay on track.

In fact, her co-author Dr. Harry Reis adds:

“The effect of marital satisfaction is every bit as important to survival after bypass surgery as more traditional risk factors like tobacco use, obesity, and high blood pressure.”

But the marriage advantage plays out differently for men and women. For men, marriage in general is linked to higher survival rates, whether the man rates his marriage as happy or not. Just the mere state of being married apparently makes men healthier. But the more satisfying the marriage, the higher the rate of survival.

But for women, it’s all about the quality of the relationship that’s even more important. While unhappy marriages provide virtually no survival bonus for women, satisfying unions increase a woman’s survival rate almost fourfold, the study found. Dr. Reis explains:

“Wives need to feel satisfied in their relationships to reap a health dividend.”

These findings mirror previous studies from the University of Utah that found women in general respond to unhappy marriages by being three times more likely to develop metabolic syndrome – a cluster of serious cardiac risk factors that can lead to heart disease.  For example, women who report high levels of marital strain are also more likely to report depression, high blood pressure, high LDL (bad) cholesterol, obesity, and other signs of metabolic syndrome.

Meanwhile, the University of Rochester researchers tracked 225 people who had bypass surgery between 1987 and 1990. They asked married participants to rate their relationship satisfaction one year after surgery. The study adjusted for age, sex, education, depression, tobacco use, and other factors known to affect survival rates for cardiovascular disease.  Then 15 years after surgery, here’s what they found during their follow-up:

  • 83% of happily wedded wives were still alive, versus only 28% of women in unhappy marriages and 27% of unmarried women
  • The survival rate for contented husbands was also 83%
  • Even the not-so-happily married men fared well had a survival rate of 60%, significantly better than the 36% rate for unmarried men.

Dr. King further explained that coronary bypass surgery is not the “miracle cure for heart disease we once thought it was”:

“But now we know that for most patients, grafts are a temporary patch, even more susceptible to clogging and disease than native arteries. So, it’s important to look at the conditions that allow some patients to beat the odds.”

Dr. King is also skeptical of the widespread belief that a major health scare like going through bypass surgery leads to life-changing behaviour. She says:

“The data show that many people go back to the lifestyle that they had before.”

Dr. King also reported that this study points to the importance of ongoing relationships for both men and women. Supportive spouses most likely help by encouraging healthy behaviour, like increased exercise or smoking cessation, which are critical to longterm survival from heart disease.

She also suggests that a nurturing marriage provides patients with sustained motivation to care for oneself and a powerful reason to “stick around so they can stay in the relationship that they like.” These are qualities of the relationship that likely existed before bypass surgery, and continued afterward, says Dr. King.

The study also cites earlier research showing that people with lower hostility in their marriages have less of the kind of inflammation that is linked to heart disease, which may help explain why people in this study benefited from satisfying marriages. And in another study, people whose relationships were on the rocks were 34% more likely to suffer a heart attack or other coronary event.

In 2005, The Framingham Offspring Study reported at the 2nd International Conference on Women, Heart Disease & Stroke suggested that women who reported “keeping their mouths shut” during conflict with their spouse – an indication of resentment over buried issues – had four times the risk of dying from heart disease over a 10-year follow up study.

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