In Brief

Severe marital stress can triple the risk of having a recurrent coronary event for women who have coronary heart disease, according to new research from Sweden.

Researchers from the Karolinska Institutet in Stockholm followed 292 women for about five years after they had been hospitalized for acute myocardial infarction or unstable angina pectoris. They found that those with high ratings for marital stress in structured interviews were 2.9 times more likely to have further coronary heart problems compared with those with little or no marital stress, according to the report in the Journal of the American Medical Association, (Vol. 284, No. 23). That effect held true even after researchers took into account a list of other factors, including age, estrogen status, education, smoking and several medical status indicators.

The study's authors, including psychologist Neil Schneiderman, PhD, of the University of Miami Behavioral Research Center, say the work is apparently the first to look at whether marital stress has an adverse effect for coronary heart disease in women, although the condition is the number one killer in both men and women. Previous studies have, however, found that women who perceive a lack of social support are more likely to have a heart attack.

The Swedish study also examined whether stress at work increased a woman's chances of heart problems but found no correlation, although studies have found work stress increases men's risk of coronary heart disease. In addition, the Swedish found no increased ill effects for women who lived alone without partners.

The researchers note that emotional strain and a lack of social support may add to women's poor health in two ways: by discouraging them from following healthy lifestyles or medical regimens and by inducing damaging effects on neuroendocrine and physiological regulatory mechanisms.