Annals of Behavioral Medicine

, Volume 35, Issue 2, pp 239–244 | Cite as

Is There Something Unique about Marriage? The Relative Impact of Marital Status, Relationship Quality, and Network Social Support on Ambulatory Blood Pressure and Mental Health

  • Julianne Holt-LunstadEmail author
  • Wendy Birmingham
  • Brandon Q. Jones
Rapid Communications



Having close social relationships and being married specifically have been reliably associated with health benefits including lower morbidity and mortality.


The purpose of this study was to examine the influence of marital status, relationship quality, and network support on measures of psychological and cardiovascular health.


We examined ambulatory blood pressure (ABP) among 204 married and 99 single males and females (N = 303).


We found that both marital status and marital quality were important. Married individuals had greater satisfaction with life (SWL) and blood pressure dipping than single individuals. High marital quality was associated with lower ABP, lower stress, less depression, and higher SWL. Importantly, contrasting those who are unmarried with those in low-quality marriages, we find that single individuals had lower ABP—suggesting that single individuals fare better than their unhappily married counterparts. Likewise, having a supportive network did not moderate (i.e., buffer) the effects of being single or unhappily married.


Findings indicate being married per se is not universally beneficial, rather, the satisfaction and support associated with such a relationship is important. However, marriage may be distinctive, as evidence further suggests that support from one’s network does not compensate for the effect of being single. These results highlight the complexities in understanding the influence of social relationships on long-term health, and they may help clarify the physiological pathways by which such associations exist.


Marriage Social support Ambulatory blood pressure Cardiovascular Stress Depression 



This research was generously supported by grants awarded to Dr. Julianne Holt-Lunstad from the Marchionne Foundation and the Family Studies Center at Brigham Young University.


  1. 1.
    Berkman LF. The role of social relations in health promotion. Psychosom Med. 1995; 57: 245–254.PubMedGoogle Scholar
  2. 2.
    House JS, Landis KR, Umberson D. Social relationships and health. Science. 1988; 241: 540–545.PubMedCrossRefGoogle Scholar
  3. 3.
    Johnson NJ, Backlund E, Sorlie PD, Loveless CA. Marital status and mortality: The National Longitudinal Mortality Study. Ann Epidemiol. 2000; 10: 224–238.PubMedCrossRefGoogle Scholar
  4. 4.
    Gove WR, Hughes M, Style Briggs C. Does marriage have positive effects on psychological well-being of the individual? J Health Soc Behav. 1983; 24: 122–131.PubMedCrossRefGoogle Scholar
  5. 5.
    Robins L, Regier D. Psychiatric disorders in America. New York: Free Press; 1991.Google Scholar
  6. 6.
    Friedman HS, Tucker JS, Schwartz JE, et al. Psychosocial and behavioral predictors of longevity: the aging and death of the “Termites”. Am Psychol. 1995; 50: 69–78.PubMedCrossRefGoogle Scholar
  7. 7.
    Ross CE, Mirowsky J, Goldsteen K. The impact of the family on health: the decade in review. J Marriage Fam. 1990; 52: 1059–1078.CrossRefGoogle Scholar
  8. 8.
    Coyne JC, Rohrbaugh MJ, Shoham V, et al. Prognostic importance of marital quality for survival of congestive heart failure. Am J Cardiol. 2001; 88: 526–529.PubMedCrossRefGoogle Scholar
  9. 9.
    Gallo LC, Troxel WM, Matthews KA, Kuller LH. Marital status and quality in middle-aged women: associations with levels and trajectories of cardiovascular risk factors. Health Psychol. 2003; 22: 453–463.PubMedCrossRefGoogle Scholar
  10. 10.
    Grewen KM, Girdler SS, Light KC. Relationship quality: effects on ambulatory blood pressure and negative affect in a biracial sample of men and women. Blood Press Monit. 2005; 10: 117–124.PubMedCrossRefGoogle Scholar
  11. 11.
    Lepore SJ. Social conflict, social support, and psychological distress: evidence of cross-domain buffering effects. J Pers Soc Psychol. 1992; 63: 857–867.PubMedCrossRefGoogle Scholar
  12. 12.
    Pearlin LI, McCall ME. Occupational stress and marital support: a description of microprocesses. In: Eckenrode J, Gore S, eds. Stress between work and family. New York: Plenum Press; 1990: 39–60.Google Scholar
  13. 13.
    Umberson D. Gender, marital status and the social control of health behavior. Soc Sci Med. 1992; 34: 907–917.PubMedCrossRefGoogle Scholar
  14. 14.
    Robels TF, Kiecolt-Glaser JK. The physiology of marriage: pathways to health. Physiol Behav. 2003; 79: 409–416.CrossRefGoogle Scholar
  15. 15.
    Burman B, Margolin G. Analysis of the association between marital relationships and health problems: an interactional perspective. Psychol Bull. 1992; 112: 39–63.PubMedCrossRefGoogle Scholar
  16. 16.
    Perloff D, Sokolow M, Cowan R. The prognostic value of ambulatory blood pressure. JAMA. 1983; 249: 2793–2788.CrossRefGoogle Scholar
  17. 17.
    Fallo F, Barzon L, Rabbia F. Circadian blood pressure patterns and life stress. Psychother Psychosom. 2002; 71: 350–356.PubMedCrossRefGoogle Scholar
  18. 18.
    Verdecchia P, Schillaci G, Borgioni C, et al. Gender, day-night blood pressure changes, and left ventricular mass in essential hypertension: dippers and peakers. Am J Hypertens. 1995; 8: 193–196.PubMedCrossRefGoogle Scholar
  19. 19.
    Ohkubo T, Imai Y, Tsuji I, et al. Relation between nocturnal decline in blood pressure and mortality. Am J Hypertens. 1997; 10: 1201–1207.PubMedCrossRefGoogle Scholar
  20. 20.
    Ohkubo T, Hozawa A, Yamajuchi J, et al. Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: The Ohasama Study. J Hypertens. 2002; 20: 2183–2189.PubMedCrossRefGoogle Scholar
  21. 21.
    Verdecchia P, Schillaci G, Borioni C, et al. Nocturnal pressure is the true pressure. Blood Press Monit. 1996; 1: S81–S85.Google Scholar
  22. 22.
    Cacioppo JT, Malarkey W, Kiecolt-Glaser JK, et al. Heterogeneity in neuroendocrine and immune responses to brief psychological stressors as a function of autonomic cardiac activation. Psychosom Med. 1995; 57: 154–164.PubMedGoogle Scholar
  23. 23.
    Locke HJ, Wallace KM. Short marital-adjustment and predication tests: their reliability and validity. Marriage and Family Living. 1959; 21: 251–255.CrossRefGoogle Scholar
  24. 24.
    Spanier GB. Measuring dyadic adjustment: new scales for assessing the quality of marriage and similar dyads. J Marriage Fam. 1976; 38: 15–28.CrossRefGoogle Scholar
  25. 25.
    Cohen S, Hoberman HM. Positive events and social supports as buffers of life change stress. J Appl Soc Psychol. 1983; 13: 99–125.CrossRefGoogle Scholar
  26. 26.
    Radloff SL. The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977; 1: 385–401.CrossRefGoogle Scholar
  27. 27.
    Diener E, Emmons RA, Larsen RJ. The Satisfaction With Life Scale. J Pers Assess. 1985; 49: 71–75.PubMedCrossRefGoogle Scholar
  28. 28.
    Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983; 24: 385–396.PubMedCrossRefGoogle Scholar
  29. 29.
    White WB, Lund-Johansen P, Omvik P. Assessment of four ambulatory blood pressure monitors and measurements by clinicians versus intraarterial blood pressure at rest and during exercise. Am J Cardiol. 1990; 65: 60–66.PubMedCrossRefGoogle Scholar
  30. 30.
    Kamarck TW, Shiffman SM, Smithline L, et al. Effects of task strain, social conflict, and emotional activation on ambulatory cardiovascular activity: daily life consequences of recurring stress in a multiethnic adult sample. Health Psychol. 1998; 17: 17–29.PubMedCrossRefGoogle Scholar
  31. 31.
    Marler MR, Jacob RG, Lehoczky JP, Shapiro AP. The statistical analysis of treatment effects in 24-hour ambulatory blood pressure recordings. Stat Med. 1988; 7: 697–716.PubMedCrossRefGoogle Scholar
  32. 32.
    Baker B, Helmers K, O’Kelly B, et al. Marital cohesion and ambulatory blood pressure in early hypertension. Am J Hypertens. 1999; 12: 227–230.PubMedCrossRefGoogle Scholar
  33. 33.
    MacMahon S, Peto R, Cutler J, et al. Blood pressure, stroke, and coronary heart disease. Part 1, prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet. 1990; 335: 765–774.PubMedCrossRefGoogle Scholar

Copyright information

© The Society of Behavioral Medicine 2008

Authors and Affiliations

  • Julianne Holt-Lunstad
    • 1
    Email author
  • Wendy Birmingham
    • 2
  • Brandon Q. Jones
    • 3
  1. 1.Department of PsychologyBrigham Young UniversityProvoUSA
  2. 2.Department of PsychologyUniversity of UtahSalt Lake CityUSA
  3. 3.Department of MedicineGeorge Washington UniversityWashingtonUSA

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