Change in coronary-prone behaviors in the recurrent coronary prevention project

The Recurrent Coronary Preventive Project (RCPP) demonstrated that the addition of Type A counseling to standard cardiac counseling resulted in significant reductions in Type A behavior and in a 44% reduction in reinfarction in post-myocardial infarction patients. The purpose of the present study was to describe the specific behavioural and psychosocial changes that occurred during this Type A treatment. Patients undergoing Type A counseling showed significant reductions not only in Type A behavior, but also in the Type A components of hostility, time urgency, and impatience, when compared with patients in the cardiac control group. They also showed significant decreases in depression and anger, and gains in self-efficacy, and marginally significant gains in social support and well-being. Type A counseling resulted in a dose-response relationship with most psychosocial outcomes, such that an increasing amount of treatment contacts was associated with increasing change. These data are important in that they specify a range of psychosocial factors that were influenced by treatment. These factors can be considered to be among the possible explanations for the efficacy of the RCPP treatment on the reduction of cardiac recurrences.