Prevalence of cardiovascular risk factors and concentration of C-reactive protein in Type D personality persons without cardiovascular disease

Background: Type D personality is associated with poor cardiovascular outcome in patients with coronary or peripheral arterial disease. Whether Type D personality is associated with cardiovascular risk in persons without overt cardiovascular disease remains unknown. We hypothesized that Type D personality is associated with higher prevalence of traditional cardiovascular risk factors and higher concentration of C-reactive protein. Design: Cross-sectional study. Methods: Type D personality was assessed in 453 participants without cardiovascular disease derived from an epidemiological study of obstructive sleep apnoea. An evaluation of obesity, lipid status, diabetes, blood pressure, heart rate, smoking, leisure-time physical activity and high-sensitivity C-reactive protein was performed. Results: Smoking (43% vs. 21%, P<0.001) and low leisure-time physical activity (<3 hours/week, 57% vs. 40%, P=0.003) were more prevalent, and heart rate (mean (standard deviation), 75 (10) vs. 71 (9), P=0.001) and body mass index was higher (29.8 (6.0) vs. 28.4 (4.5) kg/m(2), P=0.009) in Type D compared to non-Type D participants. The total number of risk factors was significantly higher in Type D than non-Type D participants (3.4 (1.3) vs. 3.0 (1.2), P=0.004). The concentration of C-reactive protein was higher in participants with Type D personality (median, interquartile range 1.6, 0.7-3.4 vs. 1.1, 0.6-2.6, P=0.047), although not statistically significant after adjustment for possible mediating factors. Conclusions: Among participants at high risk of cardiovascular disease, presence of Type D personality was associated with elevated body mass index and unhealthy behaviour such as smoking and low physical activity, which may have mediated the elevated concentration of C-reactive protein.