Can intimate relationships affect your heart? New study says ‘yes’

With heart disease as the leading cause of death worldwide, there is growing recognition that recovery is not only physical but also emotional and social. A new study shows that strong and supportive relationships can indeed improve heart health for individuals with cardiovascular disease. The work is described in an article in the Canadian Journal of Cardiology, published by Elsevier, which calls for intimate partners to be included in cardiac rehabilitation programs to support long-term heart health and quality of life for both members of the couple.

An evaluation of the effectiveness of couples-based interventions on modifiable cardiovascular risk factors, cardiac outcomes, mental health, and relationship quality in adults with diagnosed heart disease and their partners shows that 77% of the reviewed studies report health behavior improvements, with evidence presented for both cardiac and mental health outcomes.

“Considering the well-established literature highlighting that relationship quality impacts heart health, it is surprising that such a limited number of studies have targeted relationship quality in their interventions,” notes Heather E. Tulloch, PhD, CPsych, University of Ottawa Heart Institute. “Sometimes heart disease brings couples closer together, but often it’s a challenge for the relationship and both people in it. We’ve learned over the years that cardiac events do not only happen to the patient, but to the couple.”

Care beyond the individual

In Canada, one in 12 adults over the age of 20 has a diagnosis of heart disease, which represents 2.6 million people. In the European Union, cardiovascular disease is responsible for one third of all deaths and 20% of all deaths prior to the age of 65.

Most cardiac care focuses only on the individual patient. Couples-based programs, reviewed in the paper, aim to change that by involving both partners in recovery and lifestyle changes. This approach recognizes that partners are often key facilitators of recovery, for example, by cooking heart-healthy meals, encouraging regular physical activity, and ensuring medications are taken correctly. While there is growing evidence that these interventions can improve health behaviors, less is known about how they affect emotional adjustment or the quality of the relationship itself. The authors call for future research to focus more on emotional and relational factors to strengthen both partners’ recovery and well-being.

Real world impact

Healthcare systems are increasingly emphasizing patient-centered and family-oriented care. Couples-based approaches could help healthcare professionals better support both patients and their partners during cardiac rehabilitation. Not only will patients receive important interventions for improved health but, their partners—who may have similar cardiovascular risk factors—may also benefit.

Dr. Tulloch says, “Interventions that include the partner as an active participant and meaningfully address what’s happening in patients’ relationships ought to be developed and tested, with the aim of helping couples better cope with heart disease by enhancing their mental and physical health and the health of their relationship.”

Future outlook

The investigators propose a stepped care model within cardiac rehabilitation as a viable pathway for systematic screening and referral to appropriate services to help couples deal with distress. To address current knowledge gaps, future studies should include more diverse populations and measure outcomes for both patients and partners.

“We need to treat the heart and nurture relationships to enhance health behaviors, mental health and, possibly, cardiovascular outcomes among those with heart disease,” Dr. Tulloch concludes. “This could lead to stronger emotional and social adjustment during patients’ recovery and ultimately to better health behaviors.”