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Type A behavior pattern as a risk factor for coronary heart diseases
Insights
Type A behavior pattern, a risk factor for coronary heart disease (CHD), is prevalent in Japanese patients. This pattern is linked to disease severity and stress response, suggesting its role in CHD development.
Area of Science:
- Cardiology
- Behavioral Medicine
- Psychosomatic Medicine
Background:
- Type A behavior pattern (coronary-prone behavior pattern) is a recognized risk factor for coronary heart disease (CHD) in Western populations.
- The prevalence and impact of Type A behavior in Japanese CHD patients remain less understood.
Purpose of the Study:
- To investigate the presence and significance of Type A behavior pattern in Japanese patients with new-onset CHD.
- To explore the relationship between Type A behavior and traditional CHD risk factors, disease severity, and physiological stress responses.
Main Methods:
- Analysis of 300 new-onset CHD patients (243 acute myocardial infarction, 57 unstable angina pectoris) and healthy controls.
- Assessment of Type A behavior using the Jenkins Activity Survey (JAS).
- Evaluation of stress response via the Mirror Drawing Test (MDT), measuring blood pressure and plasma catecholamine levels.
Main Results:
- Type A behavior pattern was significantly more prevalent in CHD patients (64.6%) than in healthy controls (43.0%).
- Type A behavior was associated with the severity of coronary atherosclerosis and showed a higher stress-induced elevation in blood pressure and catecholamines compared to Type B.
- Behavior modification was challenging in post-CHD patients with administrative roles or unchanged workloads.
Conclusions:
- Type A behavior pattern is present and plays a significant role in the development of CHD among Japanese patients.
- The findings highlight the importance of considering behavioral patterns in CHD etiology and management, particularly in high-stress occupations.
Abstract:
This is a study of type A behavior pattern in patients with coronary heart diseases (CHD). Type A behavior pattern (coronary-prone behavior pattern) has been recognized as a risk factor for CHD in western countries. Three hundred patients with new onset of CHD (243 cases of acute myocardial infarction and 57 cases of unstable angina pectoris) between 1981 and 1987 were analysed from the standpoint of behavior pattern. Type A behavior pattern assessed by Jenkins Activity Survey (JAS) was found in 64.6% of subjects and in 43.0% of healthy controls (p less than 0.05). Concerning occupational position, the majority of patients in the administrative class showed type A behavior pattern. Type A behavior pattern was not related with other traditional risk factors (hypertension, hypercholesterolemia and smoking) and was related with angiographically documented severity of coronary atherosclerosis. Emotional stress load by mirror drawing test (MDT) evoked more elevation of blood pressure and plasma catecholamine level in type A patients than in type B patients. A follow-up of post CHD patients, whose occupational position belonged to the administrative class and/or whose work load did not decrease after CHD, modification of type A behavior pattern seemed to be difficult. In conclusion, we consider that type A behavior pattern exists also in Japanese CHD patients, and plays an important role in the development of CHD.