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Meta-Analysis
. 2025 Feb;48(1):111-119.
doi: 10.1007/s10865-024-00528-9. Epub 2024 Oct 28.

Personality and cardiovascular mortality risk: a multi-cohort analysis in individuals with and without pre-existing cardiovascular disease

Markus Jokela  1 , Laura Pulkki-Råback  2 , Marko Elovainio  2   3 , G David Batty  4 , Mika Kivimäki  5   6
Affiliations
Meta-Analysis

Personality and cardiovascular mortality risk: a multi-cohort analysis in individuals with and without pre-existing cardiovascular disease

Markus Jokela et al. J Behav Med. 2025 Feb.

Abstract

This study investigated the associations between personality traits of the Five Factor Model and cardiovascular mortality, with a specific focus on whether pre-existing cardiovascular conditions modified these associations. We used data from 43,027 participants across five cohort studies: Health and Retirement Study (HRS); Wisconsin Longitudinal Study (WLS); National Social Life, Health, and Aging Project (NSHAP); Midlife in the United States (MIDUS); Household, Income, and Labour Dynamics in Australia (HILDA) with a mean age 55.9 years and 6493 individuals with pre-existing cardiovascular disease. We conducted meta-analyses examining conscientiousness, emotional stability, agreeableness, openness to experience, and extraversion in relation to mortality due to coronary heart disease and stroke. During a mean follow-up of 12.1 years, 1620 participants died from coronary heart disease and 454 from stroke. Lower conscientiousness was associated with higher mortality risk from both coronary heart disease (hazard ratio per 1SD = 0.82, 95%CI = 0.75-0.90) and stroke (HR = 0.84, CI = 0.72-0.99). Lower emotional stability predicted increased coronary heart disease mortality (HR = 0.91, CI = 0.85-0.97). The association between conscientiousness and cardiovascular mortality did not differ between individuals with or without baseline cardiovascular conditions. In addition, adjustments for health behaviors and other covariates only slightly attenuated this association. Other personality traits were not associated with cardiovascular disease mortality. Our findings highlight the role of low conscientiousness, and to a lesser extent low emotional stability, in the development and progression of fatal cardiovascular disease through pathways that may extend beyond established health behaviors.

Keywords: Big five personality; Cardiovascular; Health; Personality; Stroke.

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Conflict of interest statement

Declarations. Conflict of interest: None of the authors have any competing interests. Human and animal rights: All research was performed in accordance with the research ethics outlined in the Declaration of Helsinki. Informed consent: All participants provided written or verbal informed consent to participate in the studies, and the data collections were approved by the relevant local institutional review boards.

Figures

Fig. 1
Fig. 1
Associations between personality traits and risk of coronary heart disease mortality in a Cox’s proportional hazard model including the five personality traits, age, and sex. Random-effect meta-analysis of 43,027 participants and 1620 deaths. HRS Health and Retirement Study; WLS Wisconsin Longitudinal Study; NSHAP National Social Life, Health, and Aging Project; MIDUS Midlife in the United States; HILDA Household, Income, and Labour Dynamics in Australia
Fig. 2
Fig. 2
Associations between personality traits and risk of stroke mortality in a Cox’s proportional hazard model including the five personality traits, age, and sex. Random-effect meta-analysis of 43,027 participants and 454 deaths. HRS Health and Retirement Study; WLS Wisconsin Longitudinal Study; NSHAP National Social Life, Health, and Aging Project; MIDUS Midlife in the United States; HILDA Household, Income, and Labour Dynamics in Australia
Fig. 3
Fig. 3
Associations between personality traits and coronary heart disease mortality separately by pre-existing cardiovascular disease (CVD) status at baseline, adjusted for sex and age. Pooled estimates from random-effect meta-analyses of 43,027 participants and 1620 deaths
Fig. 4
Fig. 4
Associations between personality traits and stroke mortality separately by pre-existing cardiovascular disease (CVD) status at baseline, adjusted for sex and age. Pooled estimates from random-effect meta-analyses of 43,027 participants and 454 deaths
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