Analyzed chest pain complaints (CPCs) and other cardiovascular disease (CVD) symptoms in the context of a model of personality and health that emphasizes the role of the enduring disposition of neuroticism as a determinant of perceptions of health. In Study 1, the association between CPCs and psychological distress measured by depression and low general well-being was documented for both sexes and for age groups from 25 to 74 yrs in a national sample ( N = 9,727). CPCs increased with age, but a hypothesized age by chest pain group interaction was not found. In Study 2, the direction of the casual connection was investigated in a longitudinal retrospective-predictive study of CVD diagnoses in 123 33-84 yr old males followed for periods of up to 20 yrs. Personality variables did not predict the development of CVD, but emotional instability and diffuse somatic complaints were predictive of anginal diagnoses in Ss who showed no other signs of CVD. Alternate interpretations of the differential prediction of anginal complaints from neuroticism are discussed.