What role does personality play in cardiovascular disease?

Despite the 60-year history of attempting to understand the relationship between personality and cardiovascular disease (CVD), individual dispositions that affect the manner in which people think, feel and act are not typically considered in cardiac clinical settings. To identify how persistent negative emotional states and behavioural traits impacted cardiovascular health, early studies focused on the Type A personality (competitive, aggressive) and, later on, the Type D personality (‘distressed’). Recent evidence on other personality types or behaviours, such as borderline personality disorder, alexithymia and neuroticism, suggest that it may be the core elements of these, alongside hostility and proneness to anger, that lead to atherosclerosis, endothelial dysfunction, coronary artery calcification, and inflammation. The current paper, and part 2 of the Psychology in Cardiology series, explores the evidence supporting different interventions for people with health-compromising personality factors, to assist in planning lifestyle modification.