Heart disease: Men Are From Mars, Women From Venus

It has been known for a long time that mutual antagonism between husband and wife can lead to increased risk of heart disease. It has now been possible to pinpoint the exact reason. Expression of hostility during marital disagreements can lead to hardening of coronary arteries (atherosclerosis) in women while controlling behavior of either spouse has been found to result in heart disease in men.

Dr. Tim Smith and fellow researchers from University of Utah have conducted this research on nearly 150 healthy couples, over 50 years of age. The three-year study (2002-2005) was conducted on healthy couples, devoid of cardiovascular disease. The study participants were subjected to CT examination to look for presence of calcification in the coronary arteries (arteries that supply the heart). Clogging of the coronary arteries leads to heart attack.

The coupes were allowed to discuss any topic that could lead to marital disagreement (children, household work, in-laws, money, vacation) for a period of 6 minutes during which a videotape recording of the conversation was done. The conversations were given a suitable code to establish the nature of the conversation (friendly versus hostile and submissive versus dominant). This facilitated easy analysis of the obtained data.

Comments such as 'You're too negative all the time' or 'You can be so stupid sometimes' were regarded to be hostile and dominant while statements like 'I don't want you to do that; I want you to do this' were rated to be dominant or controlling. 'I'll do what you want if you get off my back' was regarded an unfriendly submissive comment. Comments such as 'Oh that's a good idea, let's do it' reflected a warm submissive statement while one such as 'If it's important to you, I'll do what you want' was considered to be less warm.

Although some conversations seemed peaceful and calm, most of the couples displayed hostility to a level that necessitated marriage counseling. The CT exams done two days after the discussion was examined for the presence and level of calcification. Surprisingly, even asymptomatic patients were found to have calcification levels high enough to warrant a cardiac consultation.

'Women who are hostile are more likely to have atherosclerosis, especially if their husbands are hostile too. The levels of dominance or control in women or their husbands are not related to women's heart health. In men, the hostility - their own or their wives hostility during the interaction - wasn't related to atherosclerosis. But their dominance or controlling behavior - or their wives dominance - was related to atherosclerosis in husbands,' said Dr. Smith.

'To sum it all up, hostility during marital disputes was bad for women's hearts, while controlling behavior during marital disputes was bad for men's hearts. Disagreements are an unavoidable fact of relationships. But the way we talk during disagreements gives us an opportunity to do something healthy,' concluded Dr. Smith.

The results of the present study have valuable implications regarding cardiac health of men and women. One, heart diseases in men and women arise due to different reasons. Different treatment strategies might therefore be needed to prevent and treat cardiac disease in either sex. Second, it highlights the importance of a close, quality relationship between the husband and wife for both physical and mental health. Third, the research also throws light on how something as simple as a mutual conversation could lead to a progressive, yet silent cardiovascular disease.

May be perhaps it is time for Cardiologists to say, 'Concentrate on your marital relationship', when questioned about preserving cardiac health.