Married women who keep silent during marital disputes have a greater chance of dying from heart disease and other conditions than women who speak their minds. But the same can’t be said of married men who keep disagreements to themselves. They had the same life expectancy during the 10-year study as men who spoke out.

The research, conducted from mid-1980s to mid-1990s, was the latest to show that how couples fight affects not only their relationship but their health.

Lead author Elaine A Eaker, a Gaithersburg epidemiologist, said the message for women was clear. “When in conflict with your spouse, it helps to express yourself,” she said.

The study of 3,000 men and women published online in Psychosomatic Medicine set out to examine the relationship between marital stress and coronary heart disease or death. Participants were asked what issues they fought over and whether workplace problems spilled into their lives at home. In general, marriage benefits health, particularly of men. Married men live seven years longer and married women live two years longer than single men and women. Married people as a group also have better psychological health than never-marrieds.

When happy couples are compared with the unhappy ones, however, the effect of marriage on health is more nuanced. Studies have linked marital discord to a higher risk of recurrent heart attack in women aged 30 to 65 and the severity of congestive heart failure in male and female patients.

Recently, researchers studying married couples have identified certain behaviors that appear to worsen health risks, particularly for women.

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