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Marital Status, Marital Quality, and Atherosclerotic Burden in Postmenopausal Women

Gallo, Linda C. PhD; Troxel, Wendy M. MS; Kuller, Lewis H. MD, DrPH; Sutton-Tyrrell, Kim DrPH; Edmundowicz, Daniel MD, and; Matthews, Karen A. PhD

doi: 10.1097/01.PSY.0000097350.95305.FE

Summary Marriage confers health benefits for men, but the evidence for women is less consistent. Inconsistent findings may be attributed, in part, to the confounding of marital status and marital quality.

Objectives The authors examined whether women in satisfying marriages evidence lesser atherosclerosis relative to women in low-satisfying marriages and relative to unmarried women.

Materials and Methods Three hundred ninety-three women from the Healthy Women Study participated in this study. Marital status and quality were assessed at baseline when women were premenopausal. Cardiovascular risk factors were also assessed at baseline to determine potential mediators. Markers of atherosclerotic burden—B-Mode ultrasound measures of intima-media thickness and plaque in the carotid arteries and electron beam computed tomography assessments of calcification in the aorta and coronary arteries—were performed, on average, 11 years and 14 years later, respectively. A subset of women underwent a second ultrasound scan approximately 3 years after their first scan.

Results Women in satisfying marriages had the least atherosclerosis in the carotid arteries and aorta, especially relative to those in low-satisfying marriages. Women in satisfying marriages also tended to show less rapid progression of carotid atherosclerosis relative to women in low-satisfying marriages. Women who did not have a partner had intermediate levels of atherosclerosis. Risk factors measured at baseline contributed to the differences between the satisfied and low-satisfied groups, but not those between the satisfied and unmarried groups.

Conclusions High-quality marriages may protect against cardiovascular disease for women. Studies concerning marriage and cardiovascular health in women should, therefore, concurrently examine marital quality and marital status.

From SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego State University (L.C.G.), the Department of Psychology (W.M.T.), and the Graduate School of Public Health (L.H.K., K.S.T), University of Pittsburgh, and the Departments of Psychiatry (K.A.M.) and Medicine (D.E.), University of Pittsburgh School of Medicine, Pittsburgh, PA.

Address correspondence and reprint requests to: Karen A. Matthews, Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O’Hara Street, Pittsburgh, PA 15213.

Received for publication January 22, 2003; revision received April 11, 2003.

This research was supported by NHLBI grant HL28266, the Pittsburgh Mind Body Center (HL65111 and HL65112), NIH training grant HL07560, and by NIMH grant MH6610101.

Copyright © 2003 by American Psychosomatic Society
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