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Changes in marital quality over 6 years and its association with cardiovascular disease risk factors in men: findings from the ALSPAC prospective cohort study
  1. Ian Bennett-Britton1,
  2. Alison Teyhan1,
  3. John Macleod1,
  4. Naveed Sattar2,
  5. George Davey Smith1,3,
  6. Yoav Ben-Shlomo1
  1. 1 School of Social and Community Medicine, University of Bristol, Bristol, UK
  2. 2 Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
  3. 3 MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
  1. Correspondence to Dr Ian Bennett-Britton, School of Social and Community Medicine, University of Bristol,Bristol, BS8 2PS, UK; ian.bennett-britton{at}


Background Marital relationship quality has been suggested to have independent effects on cardiovascular health outcomes. This study investigates the association between changes in marital relationship quality and cardiovascular disease (CVD) risk factors in men.

Methods We used data from The Avon Longitudinal Study of Parents and Children, a prospective birth cohort study (Bristol, UK). Our baseline sample was restricted to married study fathers with baseline relationship and covariate data (n=2496). We restricted final analysis (n=620) to those with complete outcome, exposure and covariate data, who were married and confirmed the study child’s father at 6.4 years and 18.8 years after baseline. Relationship quality was measured at baseline and 6.4 years and operationalised as consistently good, improving, deteriorating or consistently poor relationship. We measured CVD risk factors of blood pressure, resting heart rate, body mass index, lipid profile and fasting glucose at 18.8 years after baseline.

Results Improving relationships were associated with lower levels of low-density lipoprotein (−0.25 mmol/L, 95% CI −0.46 to −0.03) and relative reduction of body mass index (−1.07 kg/m2, 95% CI −1.73 to −0.42) compared with consistently good relationships, adjusting for confounders. Weaker associations were found between improving relationships and total cholesterol (−0.24 mmol/L, 95% CI −0.48 to 0.00) and diastolic blood pressure (−2.24 mm Hg, 95% CI −4.59 to +0.11). Deteriorating relationships were associated with worsening diastolic blood pressure (+2.74 mm Hg, 95% CI 0.50 to 4.98).

Conclusions Improvement and deterioration of longitudinal relationship quality appears associated with respectively positive and negative associations with a range of CVD risk factors.

  • cohort study
  • cardiovascular risk factors
  • marital quality
  • male health

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  • Contributors IBB: co-conceived research question, cleaned data, co-wrote and performed statistical analysis, interpreted data, drafted and revised paper. He is guarantor. AT: co-wrote statistical analysis plan, interpreted data drafted and revised paper. JM: drafted, revised the paper and is a co-director of the ALSPAC project. NS: drafted and revised paper and was responsible for blood biomarker measurements. GDS: drafted, revised paper and secured funding to maintain ALSPAC data collection and the resource. YB-S: organised the data collection for the FoF clinic, co-conceived research question, co-wrote statistical analysis plan, supported the data analysis, drafted and revised paper.

  • Funding The UK Medical Research Council and the Wellcome Trust (Grant ref: 102215/2/13/2) and the University of Bristol provide core support for ALSPAC. GDS works within the Medical Research Council Integrative Epidemiology Unit at the University of Bristol (MC_UU_12013/1). IBB is an Academic Clinical Fellow in Primary Care funded by the National Institute of Health Research. Funding bodies had no influence over the content of this manuscript.

  • Competing interests This publication is the work of the authors andIB-B willserve as guarantor for the contents of this paper.

  • Ethics approval Ethical approval was obtained from the ALSPAC Ethics and Law Committee, Local Research Ethics Committees and NHS National Research Ethics Service Committee (North West – Haydock). Full references for the ALSPAC study ethics approval are available online.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement A fully searchable ALSPAC data dictionary is available online. Sharing of ALSPAC data is encouraged and facilitated for all researchers from all disciplines across the world to maximise use of the resource. For more information on data applications please see the ALSPAC website.

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