Heart patients considered “chronically distressed” (Type D personality) are at a higher risk of recurrent cardiac events.

Type D personality is associated with higher risk of future psychological problems such as depression or anxiety in heart patients.
Heart patients with the distressed (Type D) personality profile may face a higher risk of future cardiovascular problems, according to a summary article published in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes. An analysis of previous reports involving more than 6,000 patients found an association between the Type D personality and future cardiovascular issues among heart patients.

Type D is a personality marked by chronic negative emotions, pessimism and social inhibition. There is a 3–fold increase for Type D heart patients in risk of future cardiovascular issues such as peripheral artery disease, angioplasty or bypass procedures, heart failure, heart transplantation, heart attack or death. A Type D profile was also linked to a 3–fold increase in long–term risk of psychological conditions including clinical depression, anxiety or poor mental health. Type D patients appear to respond differently to cardiovascular stress. Type D is associated with differences in cortisol, a stress hormone that can temporarily increase blood pressure. It also may be related to elevated levels of inflammation. In addition, heart patients with Type D personality may be less likely to get regular medical checkups or communicate effectively with their physicians.