With heart disease as the leading cause of death worldwide, there is growing recognition that recovery is not only physical but also emotional and social. And now a new study shows that strong and supportive relationships can indeed improve heart health for individuals with cardiovascular disease, so that intimate partners need to be included in cardiac rehabilitation programs to support long-term heart health and quality of life for both members of the couple.
The study — “What about Love? A Review of Cardiac Rehabilitation Interventions for Patients and their Intimate Partners” by Heather E. Tulloch, Lisa-Marie Maukel, Jennifer L. Reed, Eniko Kasos, and Paul S. Greenman — was published in the Canadian Journal of Cardiology.
Cardiovascular health is, of course, a big issue. In Canada, as an example, one in 12 adults over the age of 20 has a diagnosis of heart disease, which represents 2.6 million people. In the European Union, cardiovascular disease is responsible for one third of all deaths and 20% of all deaths prior to the age of 65.
However, according to the researchers, most cardiac care focuses only on the individual patient. They, therefore, reviewed couples-based programs that aim to involve both partners in recovery and lifestyle changes. This approach recognizes that partners are often key facilitators of recovery, for example, by cooking heart-healthy meals, encouraging regular physical activity, and ensuring medications are taken correctly.
“While there is growing evidence that these interventions can improve health behaviors, less is known about how they affect emotional adjustment or the quality of the relationship itself,” the researchers stressed.
After an evaluation of the effectiveness of couples-based interventions on modifiable cardiovascular risk factors, cardiac outcomes, mental health, and relationship quality, the researchers found that 77% of the reviewed studies report health behavior improvements, with evidence presented for both cardiac and mental health outcomes.
Not surprisingly, according to the researchers, “healthcare systems are increasingly emphasizing patient-centered and family-oriented care. Couples-based approaches could help healthcare professionals better support both patients and their partners during cardiac rehabilitation. Not only will patients receive important interventions for improved health but, their partners — who may have similar cardiovascular risk factors — may also benefit.”
According to co-author Tulloch: “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.”
The researchers proposed a “stepped care model” within cardiac rehabilitation as a viable pathway for systematic screening and referral to appropriate services to help couples deal with distress.
“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 said. “This could lead to stronger emotional and social adjustment during patients’ recovery and ultimately to better health behaviors.”
