“In sickness and in health, to love and to cherish, ’til death do us part.” We often hear this phrase right before couples say “I do” on their wedding day, and it serves as a symbol for their emotional bond. Let’s face it: It feels pretty great to have someone to share life with, no matter the type of romantic partnership.

Turns out, it’s not just emotional benefit you can gain from a relationship. There’s also evidence that stable long-term partnerships have health benefits, including a lowered risk of depression and longer lifespan. Happy couples even tend to reap heart-specific benefits like lowered risk of heart attack and stroke, per Harvard Health Publishing.

Surprisingly, though, there are some potential negative effects in some cases.

Here, a cardiologist and licensed marriage counselor explain how certain relationship habits can affect a couple’s heart health and blood pressure, and the best ways to keep your heart healthy if you’re coupled up and like to share, well, everything with your SO.

Is marriage good for your heart?

“Research confirms there are proven health benefits of supportive relationships in general, and marriage in particular,” says Stacey Rosen, MD, a cardiologist at Northwell Health and American Heart Association Go Red for Women volunteer expert.

It’s true: A December 2017 study in the Journal of the American Heart Association (JAHA) found unmarried people with heart disease were 52 percent more likely to have a heart attack or die from heart issues after four years compared to married people.

The death rate for married people is also lower than for those who were never married, divorced, or widowed, according to the National Center for Health Statistics.

Part of the reason why? “Studies have shown physical intimacy, such as holding hands or hugging, can lower levels of stress hormones,” which, in turn, can positively affect your health, says Dr. Rosen.

Our stress hormones, namely cortisol, can directly affect our heart health and function when they’re too high. Mild stress is a normal part of everyday life, but consistently high cortisol levels (aka, chronic stress) put you at risk for heart disease, according to the University of Rochester Medical Center.

An April 2017 study in Psychoneuroendocrinology suggests that in most cases, married people have lower levels of cortisol. In the study, nearly 600 healthy adults between ages 21 and 55 were split into three groups: currently married, previously married, and never married. Their cortisol levels were tracked and tested with saliva samples during different times of the day. Researchers found married people had a bigger drop in cortisol throughout the day when compared with the never-married group, while differences between the married and previously married groups were minor.

No relationship is ever completely stress-free (especially if you’re going through a rough patch), but the stress-relieving properties of holding your SO or spending time with them could positively affect your heart in the long term.

On top of this, “a supportive partner might also encourage you in healthy ways—to exercise, eat better, or see a doctor when you need one,” which also has a positive effect on your heart, adds Dr. Rosen.

“A supportive partner might also encourage you in healthy ways, like exercising, eating better, or seeing a doctor when you need one.”—Stacey Rosen, MD, cardiologist

The link to high blood pressure

In general, the concept of “sharing” is to be expected in a marriage. Romantic partners often share things like finances, property, chores, family responsibilities, and maybe even friends. But according to a December 2023 multi-country study in JAHA, researchers found that married couples can also “share” high blood pressure.

This could largely be in part because couples tend to share behavioral and lifestyle factors—like diet, sleep patterns, and stress levels—that can negatively affect blood pressure, explains Dr. Rosen.

For example, “in marriages, we often find that couples eat meals together, and their habits can mirror each other. If one is devoted to staying physically fit, that habit could rub off on the other. If one routinely stops by the drive-thru on their way home, they might also pick up fast food for their spouse,” she adds.

Marriage aside, the 2024 Heart Disease and Stroke Statistics report from the American Heart Association (AHA) shows that 48 percent of Americans have hypertension. Because of this, the odds of both partners having hypertension are more likely, as this issue affects almost half of the population, says Dr. Rosen.

“Hypertension is among the most modifiable risk factors for heart disease and stroke,” she says. “The good news about these findings is that there’s opportunity to create changes as a couple or family.”

How couples can manage high blood pressure

According to the AHA and Dr. Rosen, the best way to lower blood pressure is to control the “controllables.” That means engaging in healthy lifestyle changes like:

• Eating a well-balanced diet that’s low in sodium
• Limiting alcohol
• Avoiding tobacco
• Staying active
• Maintaining a healthy weight for your height and body shape
• Managing stress

While these changes can be achieved individually, couples are at a particular advantage because they can hold each other accountable and help each other stay on top of their personal health.

Another habit to try? “Commit to taking your blood pressure routinely, together. Look for a reading at or below 120/80, and track your progress,” says Dr. Rosen. 

Beyond blood pressure, “it’s important to know all your numbers, including cholesterol and blood sugar. Annual checkups with your doctor can help to identify your risks and the best ways to manage them,” she adds.

Heart-healthy tips for couples

Other heart-healthy ideas Dr. Rosen encourages married couples to try include the following:

• Have healthy date nights (where you cook healthy meals together or try healthier meals at restaurants)
• Walk before/after dinner
• Plan a staycation and explore your local parks
• Take a cooking class to explore a healthy new recipe
• Replace alcohol with fun, seasonal mocktails
• Engage in stress-relieving activities together (like meditation, yoga, or breathwork)

“Lifestyle changes are more likely to be maintained when done with others, so this is a great opportunity for partners to help each other achieve optimal cardiovascular health,” she says.

As couples support each other to improve and maintain physical health in their marriage, efforts to preserve emotional health are important, too—especially if you’re both managing a chronic condition like high blood pressure. We’ve learned that reducing stress hormones and nurturing emotional health can positively affect our hearts, too.

“As a couple, you are going to face dynamics in your relationship you were not expecting,” says Jeff Yoo, LMFT, a licensed marriage therapist at the Moment of Clarity Health Center. “Acceptance is the first line of defense in dealing with everything that comes with a chronic illness.”

Tools that can keep a marriage healthy include using effective communication, mutual respect, and trust, says Yoo. “By doing so you will find solutions to whatever you are going to face. Continue to be a team.”

When managing high blood pressure together, Yoo suggests couples try the following:

• Avoid isolation
• Be open and honest in communication
• Help one another take care of your needs 
• Process feelings and fears about your health together

“Start each day with a new resolve, tackle challenges from that point, and keep moving. And above all, cherish each other,” says Yoo.

“If you as a couple can remember how unique the other is and what brought you together in the beginning, it will sustain you and provide a foundation of health and wellness through all things.”

—reviewed by Jennifer Gilbert, MD, MPH