Women who force themselves to stay quiet during marital arguments appear to have a higher risk of death, a new study shows. Depression and irritable bowel syndrome are also more common in these women.

Such "self-silencing" during conflict may have provided an evolutionary survival advantage long ago, and unfortunately may be a necessity for women in abusive relationships, Dr. Elaine D. Eaker of Eaker Epidemiology Enterprises in Gaithersburg, Maryland, the study's lead author, told Reuters Health.

Eaker and her colleagues found that, over a 10-year period, the most striking finding was that women who self-silenced were four times more likely to die than women who expressed themselves freely during marital arguments.

The current study is the first, Eaker says, to look at behavior, heart disease and mortality in the context of marital relationships. While many studies have looked into marital status and quality and heart disease, she added, "We had some other questions that I think get more at the dynamics of how people really feel in a marriage, what actually happens in a marriage."

Eaker and her team looked at 3,682 men and women participating in the Framingham Offspring Study, most of whom were in their 40s and 50s at the beginning of the study. Study participants were followed for 10 years for the development of heart disease and for death from any cause.

The study confirmed that marriage is good for men's health - compared with unmarried men, husbands were nearly half as likely to die during the follow-up period.

The researchers also found that men whose wives came home from work upset about their jobs were 2.7 times as likely to develop heart disease as men with less work-stressed wives.

It's possible, Eaker and her team suggest, that a wife's problems on the job could be upsetting to a husband because he is unable to "protect" her in this arena.

"Attention has been focused on the changing roles of women," they note in the July/August issue of Psychosomatic Medicine, "the changing roles and expectations of husbands/men also need to be scrutinized and understood."

The findings underscore the importance of healthy communication within marriage, Eaker says, although she does urge that other researchers confirm the results "before we make a lot out of them."

Nevertheless, she concludes, "both spouses really need to allow another person a safe environment to express feelings when they're in conflict," both for their own health, and for the health of the relationship.

SOURCE: Psychosomatic Medicine, July/August 2007.