

The reasons why are complex, but marriage appears to reduce a persons chance of cardiovascular disease. Maria Teijeiro / Getty Images

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Have you ever wondered why the heart has always been the symbol for love? What is it about this blood-pumping dynamo of an organ that reminds us of amorous affection and relationships? Wouldn’t the brain be more appropriate? Maybe the connection comes from the fluttering in the chest that sometimes accompanies strong romantic emotions. Alternatively, it has been suggested that love and marriage in particular are good for our health. With Valentine’s day not too far behind us, we thought we would shed light on the link between marriage and reducing the risk of cardiovascular disease.

Cardiovascular disease (CVD) is a term used to describe illnesses that affect the heart or blood vessels. Primarily these include coronary artery diseases such as angina or myocardial infarction (heart attacks). Other CVD illnesses include stroke, heart failure, heart rhythm problems including sudden cardiac death and peripheral artery disease, which is poor circulation feeding leg muscles. In fact, it is estimated that 90 per cent of CVD is preventable, and that these illnesses are now the leading cause of death globally. The principal risk factors for these diseases are ones that we can’t control like genetics and family history. The ones that we can influence and are considered modifiable include high blood pressure, smoking, diabetes, lack of exercise and poor diet.

Over the years a number of studies have looked for a connection between marital status and CVD with many suggesting that being married protects you. The challenge in this work has been to untangle what associations are purely linked to the well-being that can come from being in a long-term relationship and what comes from better health behaviours related to exercise, diet and less smoking which may be encouraged by being married. The question on the minds of many is whether being single might be a risk factor for CVD in the long term.

Fortunately, researchers in Italy recently published one of the most definitive works on the subject in the January issue of the Journal of Women’s Health, hoping to answer this question with all the evidence available. They combed through over 1,000 studies to find research that compared CVD rates in single, divorced and married subjects. They also looked at common risk factors for the development of CVD, looking for differences between these groups. They found 48 studies with over 1.2 million study subjects to report their findings.

Although the studies were too different to be combined mathematically, when looking at CVD and its specific components like cardiac arrest and heart attacks, married folks almost always fared better than those who were single. These findings were persistent regardless of age, gender or even other cardiovascular risk factors. Those who had once been married or were divorced tended to fall in a middle risk category. It would seem therefore that being married means that you are less likely to get CVD and less likely to die of it.

The investigators also looked at CVD risk factors like fitness, healthy eating, smoking and high blood pressure. There again married folks had the lowest rates. The one exception was obesity where a Greek study suggested that marriage meant more pounds. In contrast, a Swedish study found that it was bachelors and bachelorettes with the bigger waistlines. These findings suggest that in general, marriage does seem to bring about healthier lifestyles. In fact, many researchers have speculated that marriage improves health by acting as a marker of better social support systems. Those who are married tend to have stronger relationships with loved ones, leading to more effort in looking after their health.

It is important to note that the link between marital status and CVD is an association and not a proven cause and effect relationship. Only an unlikely experiment, where half of study subjects would be randomly directed to marriage and half to a single life would provide definitive evidence. As a result, people probably shouldn’t think they need to get married in order to protect their heart from a heart attack and their brain from a stroke. Mostly, patients should be aware that their relationship status may be a risk factor and to take appropriate measures to ensure they are living a healthy lifestyle. And of course, it is not just marriage that counts, but the quality of the union. If a marriage is not good, it can actually increase stress, which may increase blood pressure and lead to cardiovascular disease.

It seems that those who developed the valentine symbol had it right all along, the heart is where both love and marriage can have a beneficial effect on your health.

Dr. Eddy Lang is a professor and department head for emergency medicine at the Cumming School of Medicine, University of Calgary. Rebecca Lang is a graduate student in Community Health Sciences at the University of Calgary.

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