The authors conclude from studies of patients and of normal controls that 'somatic factors are more significant than psychological ones in the genesis of coronary artery disease'. Psychological differences between the two groups were few and were explainable by social, ethnic, or economic factors, not necessarily related to the coronary disease. The 'intrinsic role of cholesterol metabolism' is important, and there appears to be no relation between emotional stress and changes in cholesterol metabolism. Emotional factors may play some part in precipitating an actual coronary occlusion. In some individuals compulsive strivings and hard work may 'create situations of physiological wear and tear', which in turn may help produce the occlusion.

These results differ from a number of previous studies on coronary disease which ascribe definite personality 'profiles' to such patients. The present work demonstrates that such 'profiles' are unsatisfactory in the study of psychosomatic illnesses.