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Components of Type A, hostility, and anger-in: relationship to angiographic findings
Insights
The Type A behavior pattern is linked to coronary artery disease (CAD) severity. Specifically, potential for hostility and anger suppression are associated with increased disease severity and symptoms in patients with CAD.
Area of Science:
- Cardiology
- Psychosomatic Medicine
- Behavioral Medicine
Background:
- Previous studies indicate a link between the Type A behavior pattern and coronary artery disease (CAD) severity.
- The Type A behavior pattern is a complex construct with multiple components.
Purpose of the Study:
- To investigate which specific components of the Type A behavior pattern are associated with the severity of coronary atherosclerosis.
- To examine the relationship between Type A components and CAD severity in patients with minimal or severe disease.
Main Methods:
- Utilized component scoring of the Type A Structured Interview (SI).
- Performed multivariate analyses controlling for major cardiovascular risk factors.
- Assessed disease severity including angina symptoms and myocardial infarction history.
Main Results:
- No significant relationship was found between the global Type A pattern and CAD severity.
- Potential for Hostility and Anger-In were significantly and positively associated with CAD severity.
- An interaction was observed: Potential for Hostility was linked to disease endpoints only in individuals high in Anger-In.
Conclusions:
- Anger and hostility, specifically Potential for Hostility and Anger-In, are critical components of the Type A pattern associated with CAD risk.
- These findings suggest that managing anger and hostility may be important for reducing cardiovascular risk.
Abstract:
Previous research has linked the Type A coronary-prone behavior pattern to angiographically documented severity of coronary atherosclerosis (CAD). The present study sought through component scoring of the Type A Structured Interview (SI) to determine what elements of the multidimensional Type A pattern are related to coronary disease severity in a selected group of patients with minimal or severe CAD. Multivariate analyses controlling for the major risk factors showed no relationship between global Type A and extent of disease. Of all attributes measured, only Potential for Hostility and Anger-In were significantly and positively associated with the disease severity, including angina symptoms and number of myocardial infarctions. Further analysis revealed that Potential for Hostility and Anger-In were interactive in their association, such that Potential for Hostility was associated with disease endpoints only for patients who were high on the Anger-In dimension. These findings support previous research in suggesting that anger and hostility may be the critical aspects of the Type A pattern in predisposing individuals to risk of CAD.