Can personality affect heart disease risk?

Remember the Type A personality? First coined back in the 1950s, the term refers to people who are aggressive, ambitious, competitive, and time-conscious. But the notion that Type As were more likely to have heart attacks than their more laid-back counterparts turned out to be untrue, as numerous studies in the 1980s and 1990s revealed.

But in the early 2000s, another personality type — Type D for distressed — began getting more attention. Type D people are anxious, irritable, and angry; they also tend to feel ill at ease in social situations and are uncomfortable opening up to others. According to a 2018 review in Current Cardiology Reports, having a Type D personality is a risk factor for cardiovascular disease. The lead author, psychologist Johan Denollet, first described Type D and created a test for it (see “Type D personality test”).

The connection makes sense. “The outward manifestation that we call personality influences what’s going on biologically at a molecular level,” says Dr. Michael C. Miller, assistant professor of psychiatry at Harvard Medical School. The negative emotions that characterize Type D temperaments trigger the body’s stress response. Repeated surges of stress hormones in the body can cause blood pressure to rise and make the blood more likely to clot. Stress also activates the immune system, triggering inflammation that damages blood vessels.

Type D personality testFor each statement, circle the number that best characterizes your answer.FalseLess falseNeutralLess trueTrue
1I make contact easily when I meet people4321
2I often make a fuss about unimportant things1234
3I often talk to strangers4321
4I often feel unhappy1234
5I am often irritated1234
6I often feel inhibited in social interactions1234
7I take a gloomy view of things1234
8I find it hard to start a conversation1234
9I am often in a bad mood1234
10I am a closed kind of person1234
11I would rather keep people at a distance1234
12I often find myself worrying about something1234
13I am often down in the dumps1234
14When socializing, I don’t find the right things to talk about1234
Negative affectivity scale: Add scores for questions 2, 4, 5, 7, 9, 12, and 13 ______________Social inhibition scale: Add scores for questions 1, 3, 6, 8, 10, 11, and 14 ______________You qualify as a type D personality if you scored 10 or higher on both scales.

Adapted from Denollet J. “DS14: standard assessment of negative affectivity, social inhibition,and Type D personality,” Psychosomatic Medicine (Jan.-Feb. 2005), Vol. 67, No. 1, pp. 89–97.

Positive personality perks?

On the flip side, people with sunnier, more optimistic personalities seem to be less likely to develop heart-related problems. “You can see how having a temperament that naturally lends itself to wiser actions would lead to better cardiovascular outcomes,” says Dr. Miller. People with generally positive outlooks on life also tend to be motivated and productive, he points out. These traits may make it easier to do things that benefit the heart, such as getting regular exercise, eating healthy food, and nurturing supportive relationships with other people.

If you have Type D tendencies, don’t feel disheartened. Many Type D people are healthy and functioning just fine, says Dr. Miller. But for those with heart disease, positive psychology–based programs are promising interventions, according to a scientific statement from the American Heart Association about the mind-heart-body connection, published Jan. 25, 2021, in Circulation. Mindfulness practices, which encourage paying attention to and accepting your emotions moment to moment, can be especially useful for grouchy, irritable people, says Dr. Miller.

“You can teach yourself to pay attention to feelings that arise in different situations and recognize that you don’t have to react. The more you sit and watch it, you realize it’s just a state of mind, which can help you put it in perspective,” he says. The Harvard Medical School Special Health Report Positive Psychology ( has information on mindfulness and related practices.

Bible verses for today’s meditation and inspiration: Matthew E. McLaren

 “Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable–if anything is excellent or praiseworthy–think about such things.” – Philippians 4:8

 “Therefore I tell you, whatever you ask for in prayer, believe that you have received it, and it will be yours.” – Mark 11:24

 “Anxiety weighs down the heart, but a kind word cheers it up.” – Proverbs 12:25

 “Who of you by worrying can add a single hour to your life?” – Luke 12:25

 “For I know the plans I have for you, declares the Lord, plans for welfare and not for evil, to give you a future and a hope.” – Jeremiah 29:11

“If you, then, though you are evil, know how to give good gifts to your children, how much more will your Father in heaven give good gifts to those who ask him!” – Matthew 7:11

 “A cheerful heart is good medicine, but a crushed spirit dries up the bones.” – Proverbs 17:22

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