High blood pressure and marital discord: Not being nasty matters more than being nice.

Abstract

Theories linking anger and blood pressure (BP) reactivity to cardiovascular disease must be able to identify naturally occurring stressors that arouse emotion with sufficient frequency to cause chronic physiologic stress. We examine the impact of normal family arguments on 43 patients (24 women, 19 men) with essential hypertension. Patients and their partners discussed a threatening disagreement for 10 min while BP and conversation were recorded. Discussing problems increased BP, but the causal pathways differed by sex. In women, hostile interaction and marital dissatisfaction were associated with increased BP; "supportive" or "neutral" exchanges were unrelated to BP. In men, BP fluctuations were related only to the patient's speech rate. These findings are consistent with other research on sex differences in communication and social problem-solving styles and implicate different mechanisms (frequent anger, active coping) through which marital discord could increase risk. Implications for intervention are considered.

Warm Partner Contact Is Related to Lower Cardiovascular Reactivity

“…In brief, marital conflict elicits pronounced and prolonged elevations in BP, HR, and stress hormones, with women often exhibiting greater reactivity to marital discord compared with men. [47][48][49][50][51] These changes are enhanced in those who report marital dissatisfaction or who use more hostile negative behaviors during the confrontation.…”

“…Those with low marital satisfaction, however, had lower ABP only if they spent less time with their stressful mates. 25 In contrast, when Ewart and colleagues 49 compared reactivity to negative, neutral, and positive or affectionate spousal interactions in a laboratory conflict task, they found that negative marital exchanges were associated with BP changes, but neutral and positive interactions were not. The effects that nonsexual but affectionate physical contacts, such as handholding and hugging, play in fostering better health profiles in married or partnered individuals is also largely unexamined.…”

The effects of the spontaneous presence of a spouse/partner and others on cardiovascular reactions to an acute psychological challenge

“…Studies measuring cardiovascular reactivity in spousal conflict interactions have observed complex effects reflecting relative hostility (Broadwell & Light, 2005;Ewart, Taylor, Kraemer, & Agras, 1991) and relative dominance (Brown, Smith, & Benjamin, 1998). Thus, marital quality, particularly for women, would seem to be worth further exploration in this context.…”

Komorbidität chronischer somatischer Erkrankung und psychischer Störungen

“…Unabhängig von der konkreten somatischen Erkrankung und den spezifischen Unterschieden zwischen verschiedenen Krankheitsbildern umfasst die psychotherapeutische Behandlung bei chronisch somatischen Erkrankungen häufig folgende Standardinterventionen (vergleiche [9,28] [59,60,61]. Psychometrisch können Ärgerreaktionen gut mit dem State-Trait-Ärger-Ausdrucksinventar (STAXI; [62]) erhoben werden.…”