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BYU study shows why 'frenemies' make blood pressure rise

Love-hate relationships may threaten your cardiovascular health by preventing your body from relaxing in everyday situations and by failing to provide social support during more stressful times.

Brigham Young University professor Julianne Holt-Lunstad reports in a study to be published Monday in the Annals of Behavioral Medicine that unpredictable and ambivalent friendships raise our blood pressure both because they don’t help us deal with stress and are themselves a source of stress.

“The type of friend we are talking about is someone we may really love or care about,” Holt-Lunstad said. “However, they can also at times be unreliable, competitive, critical or frustrating. Most people have at least a few friends, family members or co-workers that fit the bill.”

The new research also suggests that ambivalent friends may even rob us of the health benefit normally gained by sharing good news. These factors help explain Holt-Lunstad’s discovery in a previous study that our blood pressure is higher around friends for whom we have mixed feelings than people we clearly dislike.

“Our friends can be our best allies and our harshest critics,” said John Cacioppo, president of the Association for Psychological Science and a University of Chicago professor who was not involved in the research.“This research demonstrates that a more sophisticated conceptualization of our social relationships provides richer information about their impact on our health.”

Based on participation in this and previous studies, Holt-Lunstad and her collaborators found as much as half of a typical social network would be categorized as ambivalent. For people who can’t distance themselves from these kinds of friends, the next question is whether conflicted friendships could contribute to the development of cardiovascular problems such as hypertension or even clogged arteries.

“The important point is that cardiovascular disease develops slowly over time, taking decades to develop,” said Holt-Lunstad. “If such blood pressure increases are a pervasive part of your everyday life, your risk would go up.”

Holt-Lunstad and her co-authors from the University of Utah recruited more than 100 healthy people to fill out a roster listing their friends. For each friend, they answered questions such as how helpful and how upsetting the person is in different situations: Not at all, a little, somewhat, moderately, very or extremely. An ambivalent friend is at least “somewhat helpful or positive” and at times “a little upsetting.”

The researchers then randomly assigned participants to bring either a supportive or conflicted friend into the lab. Once there, the pairs took turns discussing what they do on a typical day while researchers measured their cardiovascular functioning. Then the participants listed five positive and five negative experiences that were important to them.

From the list, the researchers randomly picked as the topic of conversation either a positive or negative experience of moderate intensity. Examples of topics include almost getting in a car accident and a friend flying into town for a surprise visit. As the pair discussed the event, researchers watched the change in blood pressure and heart rate.

“As an experimenter, I did not know who had been assigned to bring a supportive friend and who had brought an ambivalent friend, but in most cases I could tell immediately just by watching,” Holt-Lunstad said.

Take for instance the man who avoided eye contact, picked at his fingernails, and made sarcastic comments while his friend talked about being falsely accused at work. That type of situation – discussing a negative experience with a conflicted friend – is when participants’ blood pressure was highest.

Throughout the session, participants who brought in a conflicted friend showed higher resting heart rates, suggesting that people do not relax as well around these friends regardless of the situation.

The researchers were surprised that participants who brought in a conflicted friend did not get the expected benefit from sharing exciting or happy experiences. Normally sharing good news generates positive emotions, which in turn boost the body’s functioning. Instead, participants who shared good news with ambivalent friends seemed to disengage from the discussion.

“Most of the research out there has focused on the positive aspects of relationships and in fact indicates that social relationships are beneficial psychologically and physically,” Holt-Lunstad said. “However, not all relationships are positive and some relationships may actually be sources of stress.”

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