Key result
Specific marital behaviors link to ~6% of coronary artery calcification variance in older spouses.
Why the study?
Marital disruption and low marital quality have shown inconsistent associations with coronary artery disease, possibly due to reliance on self-reports rather than behavioral observations and potential sex differences.
Cross-Sectional (n=308)
No
Effect estimate: 6.2% of variance (women, affiliation); 6.0% of variance (men, control)
p-value: p=<0.01 (women), <0.02 (men)
Low warmth and dominance behaviors associated with CAC by sex; hypothesis-generating and should not yet change practice.
OBJECTIVE: To examine behavioral observations of affiliation (ie, warmth versus hostility) and control (ie, dominance versus submissiveness) and prior divorce as predictors of coronary artery calcification (CAC) in older couples. In some but not all studies, marital disruption and low marital quality have been shown to confer risk of coronary artery disease (CAD). Inconsistencies might reflect limitations of self-reports of marital quality compared with behavioral observations. Also, aspects of marital quality related to CAD might differ for men and women. METHODS: Couples underwent computed tomography scans for CAC and marital assessments, including observations of laboratory-based disagreement. Participants were 154 couples (mean age, 63.5 years; mean length of marriage, 36.4 years) free of prior diagnosis of CAD. RESULTS: Controlling traditional risk factors, we found behavioral measures of affiliation (low warmth) accounted for 6.2% of variance in CAC for women, p < .01, but not for men. Controlling behavior (dominance) accounted for 6.0% of variance in CAC for men, p < .02, but not for women. Behavioral measures were related to self-reports of marital quality, but the latter were unrelated to CAC. History of divorce predicted CAC for men and women. CONCLUSIONS: History of divorce and behavioral--but not self-report--measures of marital quality were related to CAD, such that low warmth and high dominance conferred risk for women and men, respectively. Prior research might underestimate the role of marital quality in CAD by relying on global self-reports of this risk factor.
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Smith et al. (2011) conducted a cross-sectional in Asymptomatic Coronary Artery Calcification (n=308). Marital disagreement behaviors (low affiliation/warmth and high control/dominance) and history of divorce vs. High affiliation/warmth and low control/dominance (internal comparison) was evaluated on Coronary artery calcification (CAC) severity (6.2% of variance (women, affiliation); 6.0% of variance (men, control), p=<0.01 (women), <0.02 (men)). Behavioral observation of low warmth accounted for 6.2% of the variance in coronary artery calcification among older women, while high dominance accounted for 6.0% of the variance among older men.
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