How Partner Support Can Help Heart Health

Involving partners in care can be a helpful addition to traditional cardiac rehabilitation, according to a sytudy published in the Canadian Journal of Cardiology.

Your relationships, especially with a spouse or partner, can have a big impact on heart health. While most heart care focuses on individual patients, some programs are designed to involve both the patient and their partner to support healthy habits and emotional adjustment.

The current review looked at 12 randomized controlled trials involving more than 1,400 patients diagnosed with heart disease and their partners to see how effective these “couples-based” interventions are for heart disease compared with usual care or patient-only interventions. The team also examined mental health outcomes, including anxiety and depression.

“Considering the well-established literature highlighting that relationship quality impacts heart health, it is surprising that such a limited number of studies have targeted relationship quality in their interventions,” said lead investigator Heather E. Tulloch, Ph.D., CPsych, director of the Cardiovascular Health Psychology and Behavioural Medicine Laboratory at the University of Ottawa Heart Institute. “Sometimes heart disease brings couples closer together, but often it’s a challenge for the relationship and both people in it. We’ve learned over the years that cardiac events do not only happen to the patient, but to the couple.”

Most of the programs were led by nurses (58%) and focused on changing health behaviors, like eating better, exercising or taking medications as prescribed. Most participants were White, and 77% were men.

The results showed that couples-based approaches often helped patients improve these behaviors. Some heart-related measures, like cholesterol levels or health care visits, improved in certain studies, but the findings were not consistent across all studies. Mental health results were mixed (five out of eight eligible studies deemed these interventions effective), and none of the programs (zero out of three eligible studies) significantly improved the quality of the relationship itself.

“Interventions that include the partner as an active participant and meaningfully address what’s happening in patients’ relationships ought to be developed and tested, with the aim of helping couples better cope with heart disease by enhancing their mental and physical health and the health of their relationship,” said Tulloch.

Investigators said that most research on heart disease and couples’ health is limited in important ways. Many studies focus on male patients with female partners, include few racial or ethnic minorities, and rarely involve LGBTQ+ couples. This means we don’t fully understand how heart disease and relationship support affect diverse groups. Current couples-based programs also often overlook the emotional and relational needs of both partners, focusing mostly on patient behavior. Only a few studies measured how relationships or partner well-being influence outcomes, even though partner health and support can directly affect the patient’s recovery.

Overall, involving partners in heart care seems to help with healthy habits, but the effects on heart health, mental well-being and relationship quality are less clear. Investigators believe that future programs may work better if they also focus on emotional support and relationship skills, include more diverse populations, and measure outcomes for both patients and their partners. Tailoring interventions to the needs of each couple could make these programs even more effective.

“We need to treat the heart and nurture relationships to enhance health behaviors, mental health and, possibly, cardiovascular outcomes among those with heart disease,” Tulloch concluded. “This could lead to stronger emotional and social adjustment during patients’ recovery and ultimately to better health behaviors.”