An unhappy marriage can break a woman's heart, figuratively and literally. New research suggests that married women who are dissatisfied with their relationships face a higher risk for heart disease.

In a study of nearly 500 middle-aged women, researchers at the University of Pittsburgh in Pennsylvania found that marital "distress" was linked to a higher risk for heart problems, independent of other threats to heart health such as smoking, high cholesterol and high blood pressure. Moreover, women's marital woes appeared to be unique from overall stress, depression and other psychological factors in their effects on the heart.

The researchers found that women who reported marital dissatisfaction were more likely than satisfied women to have significant plaque buildup in the main artery of the heart. They were also more likely to have blockages in the carotid arteries in the neck, a known risk factor for stroke.

Of course, all marriages have their ups and downs, and this study did not look at the normal stresses that come up from time to time. Instead it looked at women's overall happiness with their husbands -- their communication, amount of time spent together, sex lives and a range of factors.

Unhappiness in a marriage may harm the heart by inflicting "wear and tear" on the body. Like stress in general, marital dissatisfaction may lead to habitual elevations in heart rate, blood pressure and stress hormones. But marital problems are likely one part the equation -- triggering behaviors that take a toll on health, including sleeplessness and changes in eating and exercise.

Annual Meeting Of The American Psychosomatic Society in Monterey, California March 13, 2001