Wives Who Bite Their
Tongues Risk Their Lives

Married women who keep quiet during conflicts with their mates greatly boost their risk of dying from any cause, a new study finds.

And married men whose wives come home upset about work are at increased risk of developing heart disease, the same research finds.

The results were presented Feb. 17 at the Second International Conference on Women, Heart Disease and Stroke in Orlando, Fla. The meeting was sponsored by the American Heart Association, the U.S. Centers for Disease Control and Prevention and other organizations.

Elaine D. Eaker, who heads an independent research firm in Wisconsin, worked with colleagues from Boston University to analyze marital discord and its effect on heart disease and overall mortality.

"We started with healthy people and said, 'OK, what happens with them if they are in a marriage with marital strain?'" Eaker said. "Other researchers have looked at the effect of marital strain on existing heart disease. They basically found that people who are in a marriage where there is negative marital strain have a worse prognosis for their heart disease."

Eaker's study included 1,769 men and 1,913 women, aged 18 to 77, all part of the Framingham Offspring Study, an ongoing community study designed to track heart disease and other social and demographic characteristics, including marital strain. Of the total participants, 1,493 men and 1,501 women were married or described their living situation as "marital." Participants were first evaluated from 1984 to 1987, then researchers tracked their health for 10 years to see if they developed heart disease or died.

Eaker noted that, during the study, "we introduced more unique measures of marital stain in which we looked at whether you speak out when in conflict or keep quiet."

Keeping quiet has been dubbed "self-silencing," Eaker said. While the men who kept quiet during a conflict did not suffer harmful health effects, the women did, she found.

"The women who said they usually or always 'self-silence' were four times more likely to die [from all causes] during the follow-up of 10 years," Eaker said. This held true even after adjusting for such factors as age, blood pressure, cholesterol and body weight.

Eaker's group also found that men who said their wives came home upset with work were more than two times likelier to develop heart disease than men without such stress.

Referring to the women who keep quiet during conflict, Eaker said, "It's not that they are timid. They are trying to preserve the relationship. They think they are doing a good thing. They may be preserving the relationship, but they aren't preserving their lives."

Eaker speculated that women who always keep quiet during a conflict may activate stress hormones that adversely affect their health.

Like other researchers, Eaker also found that married men were half as likely to die during the 10-year follow-up period as unmarried men. But married women were just as likely to die as unmarried women during the follow-up, reinforcing the finding that marriage protects men's health more than women's.

Another heart expert isn't surprised by the study's findings. Dr. Nieca Goldberg, chief of women's cardiac care at Lenox Hill Hospital in New York City, said holding in anger during conflict with a mate "is only a cosmetic approach to anger."

"Women need to learn to take better care of themselves, and try in positive ways to express their anger and to avoid the breaking point," said Goldberg, author of Women Are Not Small Men. And women should rethink the old adage about keeping the peace at all costs, she said.

In light of her findings, Eaker said doctors should consider adding questions about marital discord and the effect of a spouse's work when taking medical histories. That way, a physician can address the issues or refer the patients to counseling, if needed, she said.

Unemployment is also hard on a woman's health, according to another study that was presented at the conference: Women who have been fired or laid off from their jobs have a higher risk of getting cardiovascular disease. Researchers from the U.S. Centers for Disease Control and Prevention analyzed data from nearly 35,000 black and white women, aged 25 to 64 years old, including some who were involuntarily unemployed, some who were working and others who chose to be homemakers.

The unemployed women had the worst health, with 28 percent reporting high blood pressure and 6 percent suffering either heart attack, chest pain or stroke. In comparison, women with jobs had better health, with only 19 percent reporting high blood pressure and only 2 percent suffering cardiovascular disease.

Among the homemakers, 19 percent had high blood pressure and 4 percent reported cardiovascular disease.

More information

To learn more about following a heart-healthy lifestyle, visit the American Heart Association.

Reference Source 101
February 18, 2005

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