Ask the doc: Is marriage really good for me?

Apr. 01, 2014 @ 11:58 PM

Q: Doc, my wife made this appointment because she's worried about me. I think I'm okay.

A: Well, it's nice to see she still loves you in spite of how stubborn you are. Medical research now says you might live longer because of your marriage.

I was told once by a patient, who had known both good and bad marriages, that a good marriage was like living on a mountain of joy and happiness and a bad marriage was like living in the valley of hell-fire on a daily basis. He spoke with authority.

Modern research is (again) noticing the advantages of marriage as a study was released this past weekend at the American College of Cardiology 2014 Scientific Session. The results of studying 3.5 million people across the United States showed a 5 percent reduction in cardiovascular disease for married couples over single, divorced and widowed individuals.

The married individuals were noted as having less cerebrovascular disease (stroke), coronary artery disease (heart attacks), abdominal aortic aneurysms and peripheral vascular disease.

Curiously, being divorced or widowed was associated with an increased risk of all vascular disease compared to people who have had never been married. Maybe it isn't better to have loved and lost than to never have loved at all. I doubt it.

One of the commenters on the study, Dr Vera Bittner (University of Alabama, Birmingham) made this interesting quote: "This ... drives home the point that we cannot estimate CV risk purely on metabolic abnormalities that we can measure; psychosocial variables can also be very important. (This) adds to the literature on domains such as depression, hostility, stress without control, and social support and in general deserves further exploration."

In short, personal and mental stress causes heart attacks, strokes, etc., and a loving spouse may likely reduce the risk of this. On the other hand, a nasty divorce with a bitter ex might lead to it. And yet, the loss of a long time beloved spouse may also be a significant contributor to cardiovascular disease.

We discuss diets and exercise, measure our blood pressure and cholesterol, think about our medicines and whether or not they are helping, and worry over commercials that blare from the television. Now science is warming to the idea that the worry, or "depression, hostility, stress without control" might be leading to cardiovascular disease.

Nice to see science catching up with common sense.

I can't count the number of times I've been asked "does stress lead to heart attacks?" usually from a person who is under a tremendous burden.

But personal stress, the kind that hits to the core of us, who we are behind closed doors, from the person who knows the most about us, seems to have a real, physical impact on the level of the arteries. The opposite, close loving support and a positive relationship, seems to provide some protection.

It is remarkable to see a spouse who has lost their partner of over 50 years grieve with tears on every breath. Teenagers and young adults seem to feel they have a corner on passionate and deep love, but my experience tells me otherwise. It is a lie to believe that all marriages are most loving at their inception and less so as the years go by.

There's no other way to put it. Some marriages in their 50-plus years humble me in how they care for each other, with an occasional grumble, but a quick smile or touch of the hand and all is well. There is powerful medicine in that kind of love, harmony, acceptance-with-all-faults-known and forgiving kindness.

The opposite is unfortunately true, too. I've seen spouses released from a bondage of trapped torment when their marriage is over, either by death or divorce. It is like watching someone walk out of prison to enjoy a new life of the things they missed out on. These are the couples who look nice and happy in public and church, but behind closed doors live a life of harsh words, separate beds, lots of alcohol (in spite of a public teetotaling perception) and hours on the computer or TV to take their minds off their personal life. Their health clearly takes a toll from the negativity of a difficult relationship, as we can lie to the world forever, but we can't lie to ourselves for long.

There is a practical component to the positive effects of a good marriage. I recently saw a man in the office who was convinced for four days his chest pain was reflux. If his loving wife had not persisted, he would be in a grave right now. His scar from his bypass surgery is healing nicely. She also is making sure he takes his medicine and makes his follow-up appointments.

The research, no doubt, will continue into the impact of the mind and emotions on our physical body. To anyone who has been in a stressful, anxious and hostile relationship and then lived in a loving, accepting relationship, there isn't much about its impact on the physical body they don't know. I've seen everything from rashes to heart attacks caused by stress.

A wise older man who's been married to a "determined" (I was told not to use the phrase "high maintenance") woman for over 60 years told me this, "You fall in and out of love many times over the years. You just keep trying and make it work. And it does."

Hopefully, the vast majority of us will know that kind of love. It's good medicine.

Eric J. Littleton, M.D. is a Family Physician in Sevierville, Tenn. His new office is located at 958 Dolly Parton Parkway. Topics covered are general in nature and should not be used to change medical treatments and/or plans without first discussing with your physician. Send questions to askdrlittleton@gmail.com.