What’s love got to do with heart health?

February is a great time to ❤️ your heart.

It’s no coincidence that our major life-giving organ shares the same anatomically incorrect symbol as our impulse to form meaningful relationships.

Love and friendship — and the support they come with — actually have an impact on heart health.

“Love improves your health because if you have emotional support, you do better physically and mentally, no matter who you love and bring with you through your journey,” says Colleen Norris, a leading heart researcher at the University of Alberta.

In celebration of Heart Month, Wear Red Canada Day and Valentine’s Day, Folio asked Norris to help us count the ways love improves heart health.

Love means friendship

Norris notes that the person who loves you doesn’t have to be your spouse.

“Our results consistently demonstrate that men experience better outcomes when they are married,” she points out. “For women, they have better outcomes when they report strong social support from friends or sisters or daughters.”

Research by Norris and others shows that health-related quality of life is lower for women than for men one year following treatment for coronary artery disease, and a big factor in that is social isolation. Women with less social support are more prone to depression and less likely to follow their medication and treatment plans. Conversely, social support reduces psychological distress and enhances recovery.

“The evidence says women do better if they have a friend or a daughter or a sister — the person you go to first — and it doesn’t have to be their husband,” says Norris.

Norris points out that heart disease can even put a strain on a marriage if you only rely on your spouse for support.

“It sure is not going to improve your relationship, because both of you will feel it’s unfair — for one of you, it’s that you got sick and for the other, it’s that you have to turn your life over to taking care of your partner.”

For Norris, when she wound up in an emergency department with chest pain last year, one of her go-to people was a friend she’s known since Grade 1.

“It’s that shared history, that bond we have. She’s a person I call if something disastrous happens in my life,” Norris explains. “I just say, ‘Kath, you’ll never believe what happened!’ and we can have that conversation without any judgment.”

Norris and others use a tool called the Medical Outcomes Social Support Index in their research to capture all of the benefits that different kinds of relationships can bring to our health: emotional support (someone to listen to you), tangible help (with meals and chores), affection (someone to give you a hug) and positive social interactions (fun).

Love means support

Along with clinical guidelines for medications, diet and lifestyle changes, nursing practice has been updated in recent years to pay more attention to the intangible factors that contribute to illness and recovery.

That’s why Norris counsels clinicians to ask heart patients, “Who’s your person? Do you have someone who provides you with support, who can get you to hospital, who you can talk to about this?”

“If someone is coming in to hospital alone and no one’s coming to visit them, we can’t just send them home with all their meds for heart disease because they’re going to be back,” says Norris, who last year was awarded the King Charles III Coronation Medal by the Heart & Stroke Foundation.

“We’re not doing our job if we don’t say, ‘Do you want to talk to someone here while you’re here? How can we improve your social support?’ Because if you’re going home alone, you’re coming back again.”

Love means balance

Stress is a top risk for heart disease, especially for women, yet none of the clinicians asked Norris about her mental health throughout her time at the hospital. She has since sought counselling to better manage her stress.

“I exercise. I don’t eat junk food. I don’t smoke. And I ended up with chest pain,” she recalls. “It was stress.”

Caring for aging parents is just one of the roles that often falls to women, creating a gender imbalance that is dangerous for heart health, says Norris. In fact, her research shows that your gendered roles have more to do with heart outcomes than your sex.

Her team evaluated factors such as marital status, parenting or caregiving, income and time spent on housework. Those who scored high on behaviours typically ascribed to women — whether they were male or female — were much more likely to have a poorer recovery.

“It didn’t matter if you were a man or a woman, if you had a high score on the gender index, you were four times as likely to come back with a second heart event within the first year,” Norris says.

Gendered roles like cleaning, making meals and caring for children can become ingrained patterns in our relationships and are therefore hard to change, Norris points out. That’s why she has a beef with heart health campaigns stating that 80 to 90 per cent of cardiovascular disease is preventable.

She’s also skeptical about research that looks to include intimate partners in joint cardiac rehabilitation programs, simply because men and women have such different needs when it comes to followup.

Love means better care

“If we truly want to improve the health of women, we have to look at the person sitting in front of us,” Norris concludes. “Really doing person-centred, tailored care is a way that we get things like love to improve your heart health and your mental health.”

Heart disease shows up differently in men than in women. Men tend to get blockages in arteries, whereas women get damage to the vascular system. So it’s no surprise that the appropriate treatments are also different.

From Norris’s perspective, the ovaries are the architects of women’s health, and that holds true long after menopause, when the lack of hormones such as estrogen and progesterone takes a toll on everything from bones to sleep to heart health.

She’s pleased to see research that once cautioned against using hormone replacement therapy has now been debunked. Individualized care could look like prescribing hormones or other supplements, or identifying heart meds that work well with your other medications, for example.

Norris has teamed up with the Alberta Women’s Health Foundation to throw the third annual Gala-entines event for 350 people at Fort Edmonton as part of this year’s Wear Red Canada efforts to inform women about their risks.

“Bring your women friends, love yourself and tell each other about heart health,” Norris says. “Start spreading the news.”

Colleen Norris is a professor and associate dean of research in the Faculty of Nursing and Cavarzan Chair in Mature Women’s Health Research. She holds adjunct appointments in the cardiology and obstetrics and gynecology in the Faculty of Medicine & Dentistry, and in the School of Public Health, and is a member of the Women and Children’s Health Research Institute at the U of A.