In a stratified, random sample of 100 men and 100 women, aged 20-59 years, residing in Zutphen, the Netherlands, the hypothesis was tested that high scores on "John Henryism," a strong behavioral predisposition to cope actively with psychosocial environmental stressors, would be associated with higher blood pressure, especially among persons of lower education. In univariate analyses higher scores on John Henryism were strongly associated with higher blood pressures in men. Among women there was only an association of John Henryism and systolic blood pressure, but this association was no longer statistically significant after adjustment for potential confounders such as age, alcohol consumption, physical activity, Quetelet Index, and education. Among men, however, the association between John Henryism and systolic blood pressure remained statistically significant after adjustment for potential confounders. The association between John Henryism and blood pressure was more pronounced for men of low educational background.

In the Zutphen Study data were collected on occupation, smoking habits, blood pressure, serum cholesterol, height and weight of 856 men who were 40-59 years old in 1960. Between 1960 and 1985 detailed information was collected on mortality. The effect of socioeconomic status as indicated by occupation on 25-year mortality was studied in relation to cigarette smoking, systolic blood pressure, serum cholesterol and Body Mass Index. It was found that socioeconomic status was an important determinant of mortality only in the men who were 40-49 years old in 1960. The risk of all-cause mortality among small business owners and manual workers was more than twice as high as that of men in the highest social class. After adjustment for the influence of cigarette smoking and systolic blood pressure these relationships remained. It can be concluded that socioeconomic status was an independent risk factor for long-term all-cause mortality, in men aged 40-49.