Type D Personality and Cardiovascular Reactivity to Acute Psychological Stress: A Systematic Review and Meta-Analysis

Objectives: Type D personality has been associated with adverse cardiovascular health, with atypical cardiovascular reactions to psychological stress considered a possible mechanism of effect. However, studies examining Type D personality and cardiovascular reactions to acute stress have yielded mixed findings. Here, we conducted a systematic reviewand meta-analyses to examine if, and under what conditions, TypeD personality is associated with cardiovascular reactivity to stress; a particular focus was placed on sex and the social salience of the stressor as potential moderators of effects. Method: Electronic databases (Medline, PsycArticles, PsycInfo, CINAHL, PubMed, Web of Science) were searched for relevant publications. A total of 401 articles were retrieved and screened for eligibility. Inclusion criteria included studies with nonclinical samples employing a resting baseline period followed by a psychological stress task period and measurement of cardiovascular reactivity. Following screening and removal of irrelevant articles, 17 peer-reviewed studies were included in the review. Result: Type D personality was associated with lower blood pressure reactivity to acute psychological stress. Subgroup analyses revealed an association between Type D personality and lower cardiovascular reactivity among females, but not males. Additionally, Type D personality was primarily associated with lower cardiovascular reactivity in response to nonsocial stressors. Conclusions: Type D personality is associated with lower blood pressure reactivity to acute psychological stress, particularly among females and in response to nonsocial stressors. This lower response may be indicative of blunted cardiovascular reactivity and therefore signals an increased risk of adverse health outcomes.