Cardiovascular Reactivity During Positive and Negative Marital Interactions Jill B. Nealey-Moore Æ Timothy W. Smith Æ Bert N. Uchino Æ Melissa W. Hawkins Æ Chrisana Olson-Cerny Accepted: July 16, 2007 / Published online: 21 September 2007 Ó Springer Science+Business Media, LLC 2007 Abstract Marriage reduces risk of cardiovascular disease (CVD) but marital stress increases risk, perhaps through cardiovascular reactivity (CVR). However, previous stud- ies have lacked controls necessary to conclude definitively that negative marital interactions evoke heightened CVR. To test the specific effects of marital stress on CVR, 114 couples engaged in positive, neutral, or negative interac- tions in which speaking and task involvement were con- trolled. Compared to positive and neutral conditions, negative discussions evoked larger increases in systolic blood pressure, heart rate, and cardiac output, and larger decreases in peripheral resistance and pre-ejection period—similarly for men and women. Hence, CVR could contribute to the effects of marital difficulties on CVD. Previous evidence of sex differences in this effect might reflect factors other than simple reactivity to negative interactions. Keywords Cardiovascular reactivity Á Marital interaction Á Marital conflict Á Interpersonal circumplex Á Psychosocial risk Á Impedance cardiography Introduction Socially isolated individuals and those who report low levels of social support are more likely to develop car- diovascular disease (CVD) than are persons with more extensive and satisfying social networks (Berkman 1995; Uchino 2004). As a source of social integration and sup- port, marriage reduces CVD risk, although apparently more so for men than women (Kiecolt-Glaser and Newton 2001). Yet, marriage may also be a source of stress, contributing to CVD risk. For example, marital strain and disruption have been associated with greater atherosclerosis, hyper- tensive complications, incidence of CVD and poor prog- nosis among persons with heart disease (Baker et al. 2000; Coyne et al. 2001; Gallo et al. 2003; Matthews and Gump 2002; Orth-Gomer et al. 2000). Psychophysiological mechanisms may contribute to these effects. Increases in blood pressure (BP) and heart rate (HR) in response to stressors (i.e., cardiovascular reactivity; CVR) and related neuroendocrine responses are hypothesized to promote hypertension, atherosclerosis, stroke and coronary heart disease (CHD) (Kop 1999; Treiber et al. 2003). Individuals with higher levels of social support display attenuated physiological responses to lab- oratory stressors, and experimental manipulations of sup- port similarly reduce these responses (Kamarck et al. 1998; Leopre 1998; Uchino et al. 1996). Through this mecha- nism, support in marriage could reduce CVD risk (Cohen et al. 1994). Moreover, aversive social interactions—including mar- ital conflict—heighten these psychophysiological res- ponses (Robles and Kiecolt-Glaser 2003; Smith et al. 2003). In laboratory studies, marital conflicts evoke inc- reases over baseline in HR, BP, and neuroendocrine vari- ables (e.g., catecholamines; cortisol). These physiological J. B. Nealey-Moore (&) Department of Psychology, University of Puget Sound, 1500 N. Warner St. #1046, Tacoma, WA 98416, USA e-mail: jnmoore@ups.edu T. W. Smith Á B. N. Uchino Á C. Olson-Cerny Department of Psychology, University of Utah, Salt Lake City, UT, USA M. W. Hawkins School of Medicine, University of Washington, Seattle, WA, USA 123 J Behav Med (2007) 30:505–519 DOI 10.1007/s10865-007-9124-5