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Categories: Behavioral Health

Relationship Math for a Healthier Heart

by Farrah Hughes, PhD, ABPP

“I’ve found 94 percent of the time that couples who put a positive spin on their marriage’s history are likely to have a happy future as well. When happy memories are distorted, it’s a sign that the marriage needs help.” 
John M. Gottman, PhD, Seven Principles for Making Marriage Work

John Gottman is a psychologist who also happens to be a mathematician, and he is a world famous expert on relationships. He has studied thousands of couples in his “Love Lab” at the University of Washington. Based on his research, he has helped create some of our most effective treatments for repairing relationships. He has studied couples so long that he can watch only a few minutes of spouses talking and predict with over 90% accuracy which ones will divorce. (You can find out more at So, when you want relationship help, you can’t go wrong with information from Dr. Gottman.

We know that the quality of our relationship can affect our heart health. For example, one study showed that divorce is a big risk factor for a heart attack for both men and women. Similar research has demonstrated that women with higher stress related to an unhealthy relationship take longer to recover from a heart attack than if their relationship was healthy. Not only can unhealthy relationships increase our risk for a heart attack and make it harder to recover, but relationship quality can also affect cardiovascular disease. For example, recent studies show that men with improving relationships had lower levels of “bad” cholesterol, healthier blood pressure, and lower body weight, or BMI. Blood pressure actually worsened in men with deteriorating relationships. 

For many reasons, including our heart health, we should monitor the quality of our romantic relationship and seek help when it is suffering. Below are a few of Dr. Gottman’s findings. Think of these as formulas for relationship success:

  • In satisfied marriages, positive communications far outnumber negative communications. One negative communication can undo the work of one positive one. Think of it this way: The positive things that we say to our partners and the nice things that we do for them are all deposits into a “bank of good will.” Negative comments and behaviors can run that account into the red. Remember to focus on the small, day-to-day moments and try to really be there when your partner needs you. It’s those moments that build your relationship and keep your bank balance from falling in the red.
  • There are 4 key signs that can predict the end of a relationship: criticism, contempt, defensiveness, and stonewalling (or withdrawal). These are nicknamed “the four horseman of the marital apocalypse.” It is okay to disagree. In fact, it’s perfectly healthy! It’s the way in which we disagree that matters.

It’s not difficult to do the math: Attending to your marriage or committed relationship is probably the best thing you can do for yourself, for many reasons. If you want to seek help on your own, check out a book by Dr. Gottman, such as Seven Principles for Making Marriage Work or Why Marriages Succeed or Fail, And How You Can Make Yours Last. If you wish to seek professional help, find a licensed therapist and schedule an appointment, or ask your healthcare provider for guidance. Whatever you do, try to keep your bank balance in the black and avoid those four horsemen. Your heart will thank you!

Compared with men whose relationships were constantly good, those whose relationships were ranked as improving had lower levels of low-density lipoprotein, or “bad” cholesterol, and a lower body weight (an average of 1 BMI unit).

There were also small improvements in cholesterol levels and diastolic blood pressure, which is a measure of cardiovascular risk. Conversely, individuals in worsening relationships were found to have significantly worse diastolic blood pressure. (2017study)

2014 study

Johns Hopkins

Another 2015 study showed that divorce is a significant risk factor for heart attack, and for women, especially, the risk rises with multiple divorces, even if there’s a later remarriage.

“Some recent research shows that the effects of emotional stress may be more pronounced in women,” says Michos. For example, a 2015 study of heart attack survivors, reported in the journal Circulation, found that women had significantly higher levels of psychological stress than men, and this may explain why they also had poorer recoveries.


  • Gottman, J.M. (2000). Seven Principles for Making Marriage Work. New York: Random House.
  • Gottman, J.M. (1995). Why Marriages Succeed or Fail, And How You Can Make Yours Last. New York: Simon & Schuster.
  • The Gottman Institute;
Tags: marriage, relationships



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