Previous research have found that positive social relationships are often associated with better health and less incidence of cardiovascular disease. The assumption was based on the premise that the more friends you have, the better your health will be. However, social relationships also include marriage. And due to conflicting findings on the health benefits of social support and the increase in heart disease risk among married women, researchers decided to take into consideration the quality of the relationship rather than the quantity.

Marriages and close friendships marked by negativity, such as conflict and adverse exchanges, boost the risk of heart disease. In a shelter for abused women, you will see different faces of physically and emotionally battered women who have similar stories to tell. Some had lived through harrowing physical abuse from their husband or lover. Others had to bear a life of verbal assaults. For these women, survival meant to just accept everything and keep their mouths shut until they had mustered enough guts to escape.

A new study on marriage, communication, and death appeared in the July-August edition of the Journal of Psychosomatic Medicine and featured the finding that women who don't express themselves during disagreements with their husbands are four times more likely to die compared with women who express themselves freely. According to Dr. Elaine Eaker, author of the 10-year study, it is the first to look at the effect of marital strain in relationship to the development of heart disease and death. The study also confirmed that marriage is good for men's health, but that unmarried men were twice as likely to die as married men.

Dr. Eaker cannot exactly tell why it is so hard for some women to speak up. It may be some type of protection mechanism. There is a general notion that women are taught not to deal directly with their feelings. On the other hand, men are raised to express their anger openly. During domestic quarrels, women are usually afraid of showing their anger towards their husbands for fear of its consequence. Either due to the threat of physical violence, or fear of losing their husbands as well as financial security. And when anger builds up like stress, it can damage the heart. A case in point is the story of Vinnie, whose husband left her for a younger woman. When the new wife asked the husband to get all the kitchen wares, she allowed him without saying a word. After “self-censoring” for so long, Vinnie lost the ability to express anger. She died from heart disease.

While taking into account other factors that could contribute to heart disease, such as depression, men and women with negative aspects in relationships are prone to a high risk of heart disease, married or unmarried, notwithstanding. And for women who are used to “self-silencing”, Dr. Eaker advises that they need to learn how to express themselves more constructively and out themselves in an environment where they feel safe to do so.