The emotional tone that men and women take during arguments with a spouse can also take a toll on their health. Utah researchers have videotaped 150 couples to measure the effect that marital arguing style has on heart risk. The men and women were mostly in their 60s, had been married on average for more than 30 years and had no signs of heart disease. The couples were given stressful topics to discuss, like money or household chores, and the comments made during the ensuing arguments were categorized as warm, hostile, controlling or submissive. The men and women also underwent heart scans to measure coronary artery calcium, an indicator of heart disease risk.

The researchers found that the style of argument detected in the video sessions was a powerful predictor for a man or woman’s risk for underlying heart disease. In fact, the way the couple interacted was as important a heart risk factor as whether they smoked or had high cholesterol, says Timothy W. Smith, a psychology professor at the University of Utah, who presented the study last year to the American Psychosomatic Society.

For women, whether a husband’s arguing style was warm or hostile had the biggest effect on her heart health. Dr. Smith notes that in a fight about money, for instance, one man said, “Did you pass elementary school math?” But another said, “Bless you, you are not so good with the checkbook, but you’re good at other things.” In both exchanges, the husband was criticizing his wife’s money management skills, but the second comment was infused with a level of warmth. In the study, a warm style of arguing by either spouse lowered the wife’s risk of heart disease.

But arguing style affected men and women differently. The level of warmth or hostility had no effect on a man’s heart health. For a man, heart risk increased if disagreements with his wife involved a battle for control. And it didn’t matter whether he or his wife was the one making the controlling comments. An example of a controlling argument style showed up in one video of a man arguing with his wife about money. “You really should just listen to me on this,” he told her.

What’s particularly notable about the study is that the men and women filled out standard questionnaires about the quality of their relationships, but those answers were not a good predictor of cardiovascular risk. The difference in risk showed up only when the quality of the couple’s bickering style was assessed.

“Disagreements in a marriage are inevitable, but it’s how you conduct yourself,” Dr. Smith said. “Can you do it in a way that gets your concerns addressed, but without doing damage at the same time? That’s not an easy mark to hit for some couples.”