Unhappily Ever After: Stroke Risk Climbs With Relationship Woes

Single or unhappily married men have a higher risk of fatal stroke.

Feb. 24, 2010— -- Marital troubles are hard on everyone involved, but new research suggests that for the unhappy hubbies, a bad marriage can kill.

In an analysis of more than 10,000 middle-aged men, researchers found that those who reported that they were dissatisfied with their marriage had a 64 percent higher risk of dying from stroke than happily wed men. Single men were no better off than the discontent spouses.

"We tend to underestimate how dysfunctional relationships can cause such incredible stress," said M. Gary Neuman, marriage counselor, rabbi and author of New York Times best-seller "The Truth About Cheating." "It takes a toll on the human body."

Researchers analyzed data on Israeli government workers between 1963 and 1997 and found that 8.4 percent of men who were single in 1963 went on to die of stroke in the following decades while only 7.1 percent of married men did.

After adjusting for variables like blood pressure, smoking habits, obesity, and socioeconomic status, this difference made for a 64 percent higher risk of fatal stroke among bachelors -- a stroke risk comparable to that of men with diabetes, Uri Goldbourt, professor of epidemiology and preventive medicine at Tel Aviv University in Israel and author of the study, noted in a press release.

But marriage seemed to protect men against increased risk only insofar as the matrimony was a good one and the 3.6 percent of married men who reported being unhappy in their union had as high a risk as single men.

More research is needed to tease out what it is about the single life or matrimonial strife that could be boosting stroke risk, but marriage counselors and stroke experts have a few ideas.

Stroke and the Single Life

There are several things that could make happily married men better off, experts said.

"Being active in your love and having a companion [in life] -- these things make people calm," Neuman said. Studies show that "touch reduces high blood pressure, so it's not just that you're so darned stressed in a bad relationship, it's that you get extreme benefits to your health when you're in a positive relationship," he said.

Dr. Sidney Starkman, emergency neurology director at the UCLA Stroke Center, also pointed out that being married may make men more likely to stick to their medications.

Neuman said the caretaking involved in a functional marriage may mean that a married man is more careful about his diet, exercise, and other behaviors that could lower his risk of cardiovascular disease and stroke.

"If someone shows minimal stroke symptoms, chances are their spouse are going to say, 'Get to a hospital,' but if you live by yourself, that might not happen," Neuman said.

Conversely, an unhappy marriage could raise blood pressure, Starkman said, and Neuman emphasized the strain people live under when in a dysfunctional relationship:

"I don't think people recognize how much energy is taken up with being angry and hurt in a relationship, or feeling demeaned, abandoned or neglected," he said. "We need the comfort of companionship more than we assume."

Matrimonial Protection From Stroke

While further research might reveal relationship status as a risk factor for stroke, at this point, the connection between the two is a "provocative" one, but one that needs more investigation, Starkman said.

In the meantime, there are much greater risk factors that patients can focus on, said Dr. Patrick Lyden, chairman of the department of neurology at Cedars-Sinai Medical Center.

"Stress, including the stress of being single or unhappily married, may contribute somewhat to stroke risk. However, we know that other factors, especially blood pressure control, weight loss, and smoking cessation are far more important," Lyden says.

To combat stroke risk, he would advise patients to "quit smoking, lose weight, get your blood pressure under control, and get into the gym five or six days per week. Who knows, after all that healthy living, your marriage might [also] improve."

The findings of the analysis will be presented today at the American Stroke Association International Stroke Conference in San Antonio.

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