The current status of the coronary prone behaviour pattern.

Despite over 30 years of increasingly vigorous research it is still not possible to claim with acceptable certainty that there is an identifiable pattern of coronary prone behaviour nor to say with any confidence that the idea is misguided. The scientific process that leads from initial tentative findings through generation of a hypothesis, to rigorous and cumulative tests of that hypothesis has not happened. Instead there has been a rather erratic series of positive and negative studies, and the generation and modification of essentially rather similar hypotheses. As a result we are still in the position of claiming that there may be a pattern of behaviour that predicts CHD and that it is probable that hostility is involved. It is not clear why the idea is so persistent but it may well lie in the combination of a widely held lay belief that heart disease relates to stress and personality, with tantalizing positive findings occurring every few years. While there has been little increase in understanding of the role of behavioural factors in CHD as a result of this 30 years of endeavour there have been clinical benefits. It has clearly been shown that what are regarded as coronary prone behaviours can readily be modified and that their modification appears to confer some health benefits and no detectable health hazards.