Shouldering family demands and worries seems to increase the risk of angina, the precursor to coronary artery disease, reveals research published online in the Journal of Epidemiology and Community Health.

Previous research has indicated that rewarding personal relationships are a boost for heart health, so the authors wanted to know if the reverse might also be true.

They tracked the heart health of more than 4,500 randomly selected men and women in their 40s and 50s for six years. None had any heart problems at the start of the study in 1999.

In 2006 all participants were asked to provide information on their heart health and on the quality of their personal relationships with an intimate partner, children, other relatives, friends and neighbours.

For each category of relationship, they were specifically asked what level of demand was placed on them, degree of worry they experienced, or whether they came into conflict with those individuals - and how often.

Similarly, they were also asked how much support - both practical and emotional - individuals in these five categories provided them, and how often they did so.

The results showed that after six years almost one in 10 of both men and women (9.5% and 9.1%, respectively) had the constrictive chest pain symptoms of angina.

Unsurprisingly, those in their 50s were more likely to report angina symptoms, as were those who were less affluent and those who were depressed.

But when the different categories of personal relationships were assessed, it became clear that there was evidence of a link between fraught relationships and the risk of angina across all five categories.

The most substantial risks were for worrisome/demanding relationships with a partner or child, where the risk of angina was more than 3.5 times and twice as likely, respectively.

Excessive worries/demands from other family members were associated with an almost doubling of risk, while those from friends and neighbours posed a negligible risk.

And the higher the degree of worry/demand in a relationship, the higher was the likelihood of reporting angina symptoms.

While arguments with children, friends, and more distant relatives did not increase the risk of angina, frequent arguments with a partner boosted the risk by 44%, while those with a neighbour increased it by 60%.

The results held true even after adjustment for other influential factors, such as smoking and lack of exercise. And they indicated that supportive relationships did not counter the negative effects on heart health of worrisome or demanding relationships.

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BMJ-British Medical Journal