Additionally, the inhibition of emotions that characterizes type D personality types is strongly associated with higher cardiovascular reactivity, lower cardiovascular recovery, lower heart rate variability, carotid atherosclerosis, incidence of coronary heart disease, and cardiac mortality. The correlation between emotional suppression and cardiovascular complications has been observed in numerous different studies, including one that involved patients undergoing cardiac rehabilitation. In this study, deaths from cardiac causes were increased by a factor of four in those with type D personality, even after controlling for conventional risk factors.