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Frequency of Spousal Interaction and 3-Year Progression of Carotid Artery Intima Medial Thickness: The Pittsburgh Healthy Heart Project

From the Departments of Psychology (D.L.J., T.W.K., S.S.) and Epidemiology (K.S.-T.), University of Pittsburgh, Pittsburgh, PA; Community Health, Brown University, Providence, RI (C.J.G.).

Address correspondence and reprint requests to Denise L. Janicki, Sennott Square, 210 S. Bouquet Street, Room 4406, Pittsburgh, PA 15260. E-mail: dlj25{at}pitt.edu

Objective: We employed Ecological Momentary Assessment (EMA) real-time recording in the natural setting to determine whether spousal interaction frequency predicts 3-year progression of carotid artery intima medial thickening (IMT).

Methods: Participants were 250 healthy, older adults (M age = 61, 48% female) who, at baseline, underwent 6 days of ambulatory monitoring using electronic diaries to collect data on mood, activity, and posture, as well as current or recent (past 10 minutes) social interactions. Participants also underwent ultrasound imaging of the carotid arteries at baseline and 3-year follow-up. Spousal interaction frequency was computed as the sum of total interactions with only the spouse during the 6 days of monitoring.

Results: Spousal interaction frequency did not predict IMT change in the sample as a whole (p = .87). However, a sex by spousal interaction by marital adjustment interaction (p = .02) indicated that more frequent spousal interaction was associated with less IMT progression among men with better marital adjustment (p = .03). In contrast, frequent spousal interaction predicted greater IMT progression among women with better martial adjustment (p < .01). This effect lost significance when women’s total social interactions (sum of all interactions) were included in the model. Total social interaction frequency was an independent predictor of IMT among women but not men.

Conclusions: These findings extend those of previous research by suggesting that frequent spousal interactions may be associated with long-term cardiovascular health among happily married older men and demonstrate how sampling daily experience may enhance our understanding of the possible health benefits of marriage.

Key Words: cardiovascular disease • ecological momentary assessment • intima medial thickness • marital adjustment • spousal interaction

Abbreviations: ABP = ambulatory blood pressure; BP = blood pressure; CVD = cardiovascular disease; EMA = equals; ecological momentary assessment; IMT = intima medial thickness; SES = socioeconomic status; DAS = equals; Dyadic Adjustment Scale; LVM = left ventricular mass; PHHP = equals; Pittsburgh Healthy Heart Project; DABS = Diary of Ambulatory Behavioral States; ARIC = Atherosclerosis Risk in Communities; SNQ = Social Network Questionnaire.