Can Thoughts Make You Physically Ill? Cardiovascular Complications of Neuroticism

Abstract

Introduction: Cardiovascular diseases are among the leading causes of morbidity and mortality. In recent decades researchers have identified psychological factors which could influence the cardiovascular risk profile. Alongside traditional cardiovascular risk factors such as hypertension and hypercholesterolemia, personality traits may contribute to behavioral and immunological effects which could influence the risk of developing cardiovascular diseases. Purpose: The purpose of this literature review is to examine if high neuroticism, as described in the Big Five personality model, causes an increased risk of cardiovascular diseases (coronary heart disease and stroke). Material and methods: Two separate literature searches were conducted in MedLine (22.08.2023) and APA PsycNet (26.01.2024). In total, 139 records from the literature searches were screened and assessed for eligibility. Cohort studies published during the past 10 years which include over 1000 participants were eligible for the current review. A total of 10 cohort studies or reviews of longitudinal studies were included in the final analysis. The risk of bias was assessed with some of the principles described in the GRADE evaluation method. Results: In total, 7 out of 10 research papers found a small yet significant link between high neuroticism and the risk of developing cardiovascular disease. The HR for MI/CHD ranged between HR 1.03 (CI 1.02-1.04) and HR 1.14 (CI 1.07–1.21) in the three largest study samples included. The results indicate a small but statistically significant neuroticism mediated risk. High conscientiousness had a protective effect against heart disease. The results among stroke risk were inconsistent and did not provide sufficient evidence for indicating an association. Conclusion: This literature review found a link between high neuroticism and an increased risk of developing myocardial infarction and coronary heart disease. Nevertheless, the risk was rather small in comparison to the risk imposed by the traditional risk factors. The evidence for personality mediated stroke risk was insufficient.