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September 21, 2011

In Research

happy man and woman holding hands

Dennis Greco is enjoying life with his wife of 32 years, Susan Greco, more than a decade after undergoing bypass surgery. His secret? A happy marriage, according to a new Rochester study. The effect of marital satisfaction is “every bit as important to survival after bypass surgery as more traditional risk factors like tobacco use, obesity, and high blood pressure,” says study coauthor Harry Reis.

Is marriage good for the heart?

Happily wedded people who undergo coronary bypass surgery are more than three times as likely to be alive 15 years later as their unmarried counterparts, reports a University study published in Health Psychology, a publication of the American Psychological Association.

“There is something in a good relationship that helps people stay on track,” says Kathleen King, a professor emerita at the School of Nursing and lead author on the paper.

The effect of marital satisfaction is “every bit as important to survival after bypass surgery as more traditional risk factors like tobacco use, obesity, and high blood pressure,” says coauthor Harry Reis, a professor of psychology.

The researchers tracked 225 people who had bypass surgery between 1987 and 1990. They asked married participants to rate their relationship satisfaction one year after surgery. The study adjusted for age, sex, education, depressed mood, tobacco use, and other factors known to affect survival rates for cardiovascular disease.

Fifteen years after surgery, 83 percent of happily wedded wives were still alive, versus 28 percent of women in unhappy marriages and 27 percent of unmarried women. The survival rate for contented husbands was also 83 percent, but even the not-so-happily married fared well. Men in less-than-satisfying unions enjoyed a survival rate of 60 percent, significantly better than the 36 percent rate for unmarried men.

King says tthe study points to the importance of ongoing relationships for both men and women. Supportive spouses most likely help by encouraging healthy behavior, like increased exercise or smoking cessation, which are critical to long-term survival from heart disease.

Children’s personalities linked to their chemical response to stress

Is your kid a “dove”—cautious and submissive when confronting new environments—or perhaps you have a “hawk”—bold and assertive in unfamiliar settings?

These basic temperamental patterns are linked to opposite hormonal responses to stress—differences that may provide children with advantages for navigating threatening environments, researchers report in Development and Psychopathology.

“Divergent reactions—both behaviorally and chemically—may be an evolutionary response to stress,” says Patrick Davies, a professor of psychology and lead author of the study. “These biological reactions may have provided our human ancestors with adaptive survival advantages. For example, dovish compliance may work better under some challenging family conditions, while hawkish aggression could be an asset in others.”

Coauthor Melissa Sturge-Apple, an assistant professor of psychology agrees: “When it comes to healthy psychological behavior, one size does not fit all.”

To understand the role of stress in children’s reactions, Davies, Sturge-Apple, and Dante Cicchetti, a professor of child development and psychiatry at the University of Minnesota, focused on parental conflict in young families. The study looked at 201 two-year-old toddlers, all from impoverished families with similar socio-economic profiles. Based on interviews and questionnaires with the mothers, the authors assessed children’s exposure to levels of aggression between parents.

The researchers also documented the dove or hawk tendencies of the toddlers in a variety of unfamiliar situations. Children who showed dovish tendencies were vigilant and submissive in the face of novelty. The toddlers clung to their mothers, cried, or froze when encountering new surroundings. Hawks used bold, aggressive, and dominating strategies for coping with challenge. They fearlessly explored unknown objects and new environments.

The children were exposed to a mildly stressful simulated telephone argument between their parents. Doves with parents who fought violently produced elevated levels of cortisol, a hormone that is thought to increase a person’s sensitivity to stress, while hawks from similar home environments halt cortisol production, which is regarded as a marker for diminishing experiences of danger and alarm.

The research was supported by the National Institute of Mental Health.

Health gains from MS drugs come at a high price

A new Medical Center study shows that the health gains associated with a category of medications commonly used to treat multiple sclerosis—known as disease modifying drugs—come at a very high cost when compared to therapies that address the symptoms of MS and treatments for other chronic diseases.

The study—which appeared in the journal Neurology—analyzed data from 844 individuals with early stage MS and projected health care costs, including the cost of the drugs, and lost productivity over a 10-year period. The study found that while MS patients using disease-modifying drugs experience modest health gains, the cost associated with using drugs is more than eight times higher than what is considered “reasonable” from the perspective of the cost-effectiveness and health economics.

“While it is clear that disease-modifying drugs are beneficial to some MS patients, those gains come at a tremendous economic cost,” said Katia Noyes, an associate professor in the Department of Community and Preventive Medicine and lead author of the study. “These results point to the need to continually evaluate the cost-effectiveness of new treatments in the interest of controlling health care costs.”

MS is a disease of the central nervous system and is the most common cause of neurological disability in young adults. The disease causes muscle weakness, numbness or tingling in arms and legs, difficulty with coordination, balance and walking, blurred vision, and slurred speech.

In the 1990s several new drugs were introduced that modified the course of the disease, as opposed to traditional therapies that primarily treat the symptoms of MS. The drugs have been shown in large clinical studies to slow the progression of the disease and reduce relapses. However, the drugs are associated with side effects and are expensive, costing as much as $30,000 per year. 

Individuals taking disease-modifying drugs experienced a modest improvement in health, according to the study. For example, MS patients gained about 2 quality-adjusted months over 10 years using one drug regimen compared to those who did not take disease-modifying drugs. Patients taking a different regimen had an average of 6 out of 10 years free of relapses compared to 5 years for those not taking the drugs.  The authors also found that the benefit to patients was greater if they began taking the drugs early during the onset of the disease.

The study was funded with support from the National Center for Research Resources and the National Multiple Sclerosis Society.

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