Relation between hostility and coronary heart disease

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# Evidence does not support link {#article-title-2} EDITOR—The summary points of Hemingway and Marmot's review of psychosocial risk factors for coronary heart disease may be misleading.1 The first of these states that “prospective cohort studies show a possible aetiological role for type A/hostility.” However, of the four prospective studies of hostility, only two show any significant association between hostility and coronary heart disease (one for women only). Six of the nine aetiological studies of type A behaviour also show no association with coronary heart disease. The other three studies give no information on completeness of follow up or whether outcomes such as angina were assessed in a blinded manner. One of these studies had minimal adjustment for confounding. No study showed any prognostic role for type A behaviour or hostility. Taken together, these studies do not represent robust evidence that these psychological variables have an important role in the development or prognosis of coronary …