One possible explanation for the association between Cook-Medley Hostility Scale (Ho Scale; W. W. Cook & D. M. Medley, 1954) scores and premature coronary artery disease (CAD) morbidity and mortality is that hostile persons also have elevations on CAD risk factors. Meta-analyses with fixed and random-effects models were used to evaluate the relationship between Ho Scale scores and CAD risk factors in the empirical literature. Ho Scale scores were significantly related to body mass index, waist-to-hip ratio, insulin resistance, lipid ratio, triglycerides, glucose, socioeconomic status (SES), alcohol consumption, and smoking. Although there was also heterogeneity among study outcomes, the results of conservative random effects models provide confidence in the obtained relationships. On the basis of available evidence, researchers might give attention to obesity, insulin resistance, damaging health behaviors, and SES as potential contributing factors in understanding the association between Ho Scale scores and CAD.