Wives should express themselves in fights

Not taking a stand can hurt your health, research shows

December 20, 2007|By Dennis O'Brien | Dennis O'Brien,sun reporter

Every couple fights, right?

But in terms of their health, what they fight about is less important than how they fight, according to a Gaithersburg researcher.

Elaine Eaker, an epidemiologist who operates her own consulting firm, looked at how 3,681 men and women sort out marital differences and tracked their mortality rates and cardiac health for 10 years.

She found that women who had reported that they didn't vent during arguments were four times more likely to die than women who spoke up in a fight.

Men, on the other hand, were more likely to keep their mouths shut - and speaking up made no difference in terms of their long-term health. But Eaker found that men who said their wives brought home job-related stress were almost three times as likely to develop heart disease over the next 10 years.

"What affects physical health is whether you express yourself during conflict, if you're a woman; and if you're a man, it's whether your wife comes home from work and is stressed," Eaker said.

Men and women also reported arguing about different issues. For men, the main topic of disagreement was sex; for women it was child-raising issues. Other topics for fights were family finances, household chores, how to spend leisure time and drinking.

Eaker reported the findings in the journal Psychosomatic Medicine in July and highlighted them in a talk this month to the Sister to Sister Foundation, a women's health group in Baltimore.

Experts say the results are consistent with decades of research showing the health risks posed by prolonged stress.

"When somebody is under a lot of stress, they don't take care of themselves. They're probably not eating well, they're not sleeping well and they're probably not exercising," said Linda Grande, a clinical counselor who provides couples therapy at the Ruscombe Center in Baltimore.

Why a wife's job stress would increase her husband's risk of heart disease is unclear, said Eaker, a former researcher for the National Institutes of Health and the Centers for Disease Control and Prevention.

"Maybe she isn't relaxing and they're not supporting each other, but we don't know. There's a whole host of possibilities going on, and it should be studied further," she said in an interview.

Women who don't argue back might fear that speaking up will damage the marriage, or they might be in an abusive relationship, she said. But they might be harming themselves because they're failing to respond to stress caused by the arguments.

"There's this whole fight-or-flight thing when conflict arises, and when you're angry and upset, you may have a need for that fight-or-flight response and these women aren't doing either of them," she said. "They're sitting there and taking it."

The report is one of several recent studies showing the ill effects of stress on cardiac health.

"It's a very provocative study and a very active area of research right now," said Dr. Charles M. Blatt, a cardiologist at the Harvard Medical School who has been examining the role of stress on the heart for 20 years.

Blatt recently gave 516 patients with coronary artery disease questionnaires that measured their attitudes about their condition and found that those who scored high for anxiety were twice as likely to die or have a heart attack within three years of the diagnosis. He encourages physicians to emphasize that the diagnosis is not a death sentence.

"That decline in fear, that decline in anxiety, is therapeutic on its own," he said. His study was published May 3 in the Journal of the American College of Cardiology.

For Eaker's study, questionnaires were distributed to 1,912 women and 1,769 men during visits to doctors' offices between 1984 and 1987 as part of the national Framingham Offspring Study. On average, the volunteers were about 48 years old.

She found that over the next 10 years, 47 women and 126 men developed heart disease or had a heart attack and 92 women and 175 men had died, according to the report.

Whether women reported feeling happy or unhappy in their marriages didn't change their risk of dying or developing heart disease, she said.

When asked if they have a conflict with their spouse, 552 of the men (31 percent) and 443 of the women (23 percent) said they usually or always keep it to themselves.

The results also confirm past findings that show marriage reduces the risks of dying and developing heart disease among men, but had insignificant effects for women in those areas.

"Being married is good for men, but the benefit isn't so clear for women," said Willem Kop, director of the behavioral cardiology program at the University of Maryland School of Medicine.

At the University of Toronto, Dr. Brian Baker, a psychiatry professor, found that over the course of a year, a stable marriage was instrumental in keeping blood-pressure rates at healthy levels for 229 male and female volunteers in high-pressure jobs. He published his findings in the American Journal of Hypertension.

"If your blood pressure's high, a good marriage has a protective effect," Baker said. "The best advice is to fight fair, especially if you have high blood pressure."


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