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Is type A behavior really a trigger for coronary heart disease events?

John E J Gallacher1, Peter M Sweetnam, John W G Yarnell

  • 1Department of Epidemiology, Statistics and Public Health, University of Wales College of Medicine, Heath Park, Cardiff, UK. Gallacher@cf.ac.uk

Psychosomatic Medicine
|May 24, 2003
PubMed

Insights

Type A behavior predicts the timing, not the occurrence, of coronary heart disease (CHD). This suggests Type A behavior increases exposure to triggers rather than causing atherosclerosis.

Area of Science:

  • Cardiology
  • Behavioral Medicine
  • Epidemiology

Background:

  • Type A behavior pattern (TABP) has been historically linked to coronary heart disease (CHD).
  • The precise mechanisms, whether acute or chronic, by which TABP influences CHD risk remain under investigation.
  • Understanding these mechanisms is crucial for developing targeted prevention strategies.

Purpose of the Study:

  • To investigate the acute versus chronic mechanisms through which Type A behavior predicts incident coronary heart disease (CHD).
  • To differentiate between Type A behavior influencing the likelihood versus the timing of CHD events.

Main Methods:

  • A cohort of 2394 men aged 50-64 years was assessed for CHD, TABP, and risk factors.
  • Type A behavior was measured using the Jenkins Activity Survey (JAS), Bortner scale, and Framingham scale.
  • Participants were followed for incident CHD over a 9-year period with examinations at 5 and 9 years.

Main Results:

  • No overall increased risk of CHD was associated with any Type A score after 9 years.
  • High Bortner scores predicted increased CHD risk at 5 years.
  • High JAS and Bortner scores were associated with a decreased risk between 5 and 9 years, indicating a timing effect.
  • All Type A scores showed strong inverse associations with the time to the first coronary event.

Conclusions:

  • Type A behavior is a significant predictor of the timing of coronary events, not their occurrence.
  • These findings suggest Type A behavior may increase exposure to acute triggers for CHD events.
  • The study implies that Type A behavior's impact on CHD is more related to event precipitation than to the progression of atherosclerosis.
Abstract

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