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Personality, lifestyle, and risk of cardiovascular disease and cancer: follow-up of population based cohort

BMJ 2006; 332 doi: (Published 08 June 2006) Cite this as: BMJ 2006;332:1359
  1. Til Stürmer, visiting associate professor of medicine (til.sturmer{at},
  2. Petra Hasselbach, research fellow2,
  3. Manfred Amelang, professor of psychology2
  1. 1 Divisions of Pharmacoepidemiology and Pharmacoeconomics, and Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02120, USA,
  2. 2 Department of Psychology, University of Heidelberg, Germany
  1. Correspondence to: T Stürmer
  • Accepted 13 April 2006


Objective To study the relation between measures of personality and risk of cardiovascular disease and cancer in a large cohort.

Design Follow-up of population based cohort.

Setting Heidelberg, Germany.

Participants 5114 women and men aged 40-65 in 1992-5.

Main outcome measures Psychological traits assessed by several standardised personality questionnaires in 1992-5, related to cause of death (to 2002-3) or reported incidence of cardiovascular diseases and cancer (validated by treating doctors). Relative risks (and 95% confidence intervals) for combined morbidity and mortality according to five important personality traits were estimated using multivariable Cox proportional hazards models.

Results During median follow-up of 8.5 years, 257 participants died and 72 were diagnosed with a heart attack, 62 with stroke, and 240 with cancer (morbidity and mortality combined). A high internal locus of control over disease was associated with a decreased risk of myocardial infarction (adjusted relative risk for an increase of 1 SD = 0.75; 95% confidence interval 0.58 to 0.96). An increase of 1 SD in time urgency was associated with a decreased risk of cancer (adjusted relative risk 0.83; 0.73 to 0.95). Other major personality traits—anger control, psychoticism, and symptoms of depression—were not consistently associated with myocardial infarction, stroke, or cancer.

Conclusion Internal locus of control over disease and time urgency seem to be associated with reduced risk for common chronic diseases, probably by affecting unmeasured health related behaviour. The other personality traits assessed had no major impact on cardiovascular disease and cancer.


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  • Contributors MA and TS designed the study and obtained funding; PH collected the data; TS and PH analysed the data; TS drafted the paper; TS, PH, and MA helped to write the paper. MA is guarantor.

  • Funding German Research Foundation (research grant AM 37/19-1).

  • Competing interests None declared.

  • Ethical approval Ethics committee-I of the medical faculty of Heidelberg, Ruprecht-Karls University of Heidelberg, Germany.

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