Background: Several personality and affective traits increase risk for atherosclerotic cardiovascular disease. Because many of these traits are correlated, much of their association with disease risk could reflect shared variance, rather than unique contributions of each trait individually. Within the Five Factor Model of personality, we examined a higher-order personality trait of Stability (comprising the shared variance of Agreeableness, Conscientiousness, and inverse Neuroticism) as related to extent of preclinical atherosclerosis and tested whether any such relationship might be explained by correlated variation in cardiometabolic risk factors.Method: Among 798 community volunteers (30-54 yr; 52% women), lower-order traits of Neuroticism, Agreeableness, and Conscientiousness were modeled as latent variables (from self- and two informant ratings) and used to estimate the second-order factor, Stability. Aggregated cardiometabolic risk was similarly modeled from indicators of glycemic control, blood pressure, adiposity, and lipids. Carotid artery atherosclerosis was measured as intima-media thickness (IMT) by duplex ultrasonography.Results: A structural equation model incorporating both direct and indirect effects showed lower Stability associated with greater IMT. This relationship was accounted for by the indirect pathway via cardiometabolic risk, with no residual direct effect of Stability on IMT. Secondary analyses showed that: 1) Neuroticism, Agreeableness, and Conscientiousness were unrelated to IMT independent of their shared variance (i.e., Stability); and 2) Stability predicted variation in IMT significantly when estimated from informant-, but not self-rated, traits.Conclusion: Descriptively distinct, but correlated, personality traits may associate with atherosclerotic burden through their shared, rather than unique, variance, as reflected in the meta-trait of Stability.