Despite the growing body of evidence against Type-A behavior pattern as a risk factor for coronary heart disease, there remains much interest in the relationship between some of the Type-A components, especially hostility, and coronary heart disease. However, the construct of hostility too needs further refinement into overt-expressive hostility which correlated positively with the severity of coronary occlusion and the covert experience of hostility, or neurotic hostility, which is negatively correlated. Loud speech and the frequency of simultaneous interruptive speech are other attributes associated with coronary disease. The paper concludes with a biobehavioral model that assumes a synergistic interaction between hostility, speech style and cardiovascular reactivity.