Ambivalence and cardiovascular function: examining ambulatory blood pressure and marital quality

Prior research suggests that married adults are at lower risk for cardiovascular morbidity and mortality although being married, per se is not universally beneficial, but rather, the quality of the relationship is important. Such work has documented relationships that differ in their underlying positive and negative substrates. For instance, some close relationships are characterized by high levels of both positivity and negativity (ambivalence) which may be a significant source of stress. Couples with ambivalent relationships may not experience the same cardiovascular-protective benefits of marriage. Thus the aims of the current study were to elucidate the physiological pathways by which spousal relationship quality may ultimately influence long-term health and to examine the roles of relationship quality on daily ambulatory blood pressure (ABP), an independent predictor of cardiovascular health. Additionally, as relationships progress through multiple interactions, the behavioral styles of the spouses may be altered in ways that establish greater complimentarity. Thus an additional aim of this study was to examine relationship quality both in terms of how one perceives their spouse's underlying positive or negative behavior, and how they perceive they behave toward their spouse. We hypothesized that relationships perceived as more ambivalent would result in higher individual daily ABP and worse interpersonal processes. We also tested a meditational model based on principles of complimentarity and interpersonal processes and expected that when an individual views their spouse's behavior as ambivalent, this would significantly influence the individual's levels of ambivalence in their own behavior. We examined ABP during the day and evening among 94 married couples aged 18 to 63 (M=29.4). For our primary analyses we used Proc Mixed and analysis revealed a significant effect of relationship quality on systolic blood pressure for spousal ambivalence (SBP) (p=.01), and a significant effect of relationship quality for own behavior on SBP (p=.0002) and on diastolic blood pressure (DBP) (p=.009) such that those individuals who viewed their relationship as more ambivalent (both positive and negative) had higher SBP and DBP during daily life. Relationship quality was also associated with worse interpersonal processes such as lower reported partner responsiveness (p=.0005), intimacy (p<.0001) and greater negative affect (p=.026) for spousal ambivalence and lower reported intimacy (p=.003) and greater negative affect (p=.0016) for own ambivalence. These findings suggest that individuals may not benefit from the positivity that exists in ambivalent marriages and this may negatively influence long-term health.