The association of coronary heart and cardiovascular mortality with noise sensitivity was studied. We also investigated how this association is affected by self-reported lifetime noise exposure. In 1988 a case-control study, based on the Finnish Twin Cohort, was carried out to investigate the relationship between noise and hypertension (n=1495). Potential confounders were obtained from questionnaire in 1981 for the same individuals. Data on deaths and causes of death were obtained from record linkage to the nationwide register of death certificates. All deaths that occurred among the study population during the 15 years of follow-up were classified as being due to all causes (n=382), to cardiovascular diseases (n=193), including the number of deaths due to coronary heart diseases (n=111) and to other causes than cardiovascular diseases (n=189). Cardiovascular mortality (Hazard ratio 1.80, 95% CI 1.07-3.04) was significantly increased among noise-sensitive women. Among men, there were no statistically significant effects. Noise sensitivity may be a risk factor for cardiovascular mortality in women.