Meta-analyses of prospective studies on coronary heart disease, type A personality, and hostility

Background: Several large-scale prospective studies have failed to find an association between Type A personality (TAP) or hostility and coronary hear t disease (CHID). The existing meta-analyses on this topic have several sho rtcomings, such as a selective search of the literature, the failed use of effect sizes, and methodological flaws. Methods: The present meta-analyses cover all prospective studies until the end of 1998. The correlation coeffi cient r is used as effect size to yield information on the population effec t size R and variance. Several analyses have been carried out to stratify f or disease endpoints, samples (healthy population, CHD patients), and metho ds used to determine TAP or hostility. Results: The population effect size (weighted average of all correlation coefficients) for TAP and CHD is R=0.0 03 (n=74,326, P=0.213), and for hostility and CHD R=0.022 (n=15,038, P=0.00 3). Conclusions: The population effect size for TAP and CHD is not signific ant. Hostility yields a significant association with CHD; however, the effe ct size is so low that it has as yet no practical meaning for prediction an d prevention. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.