[Ischemic cardiopathies, environment and personality. Role of type A behavior]

Type A represents a type of behavior manifested by an almost constant pressure of time, a deep desire of social success and a considerable underlying hostility which is largely repressed. A critical study is presented in light of the results of two prospective epidemiological surveys. The evaluation methods (interview, questionnaires) are described and seem to offer a satisfactory concordance ratio. Type A is as widespread among the french populations studied (42.2%) as among the north-american populations. It is closely related to environmental pressures. Prospective surveys have shown that this type of behavior is strongly correlated with an incidence of ischemic cardiopathies and that its predictive value is independent, and equivalent, to that of major risk factors (tobacco, arterial hypertension, dyslipidemia). This predictive value seems definite, but with more magnitude for myocardial infarction than for angina. Major implications in the prevention and the treatment of ischemic cardiopathies and the direction of research programs may be considered.