Researchers tracked the incidence of heart disease in almost 2,000 women of all ages over 10 years and compared it with data on their marital disputes.

Women who confessed to keeping their feelings to themselves when in conflict with their husbands — “self-silencing” — faced more than four times the risk of dying compared with women who spoke out.

“Self-silencing may seem to be protective, because the wife may not think it acceptable to express her emotions or because she may fear anger on the part of her husband, but it may have a detrimental outcome for her health,” said Dr Elaine Eaker.

Eaker, from Wisconsin, oversaw the research to be published this month in Circulation, the journal of the American Heart Association. She added: “This is probably because, when you bottle something up, rather than letting it out, it affects your stress hormone levels.”

By contrast, research by the group already published in Circulation found hot-tempered men who explode with anger seem to be at greater risk of having a stroke. Men who unleashed their anger were 20% more likely to develop an irregular heart rhythm.

Men who are contemptuous of others are 30% more likely to develop irregular heart rhythms, it showed. However, the study did not find a significant link between hostility and the risk of heart problems in women.

One lesson from the study is that men and women are different, emotionally and physically, said Eaker. “Men have this explosion of irrational anger that is not good for their health. The message is not to have angry outbursts but to express your feelings in a constructive way.”

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