Sympathoadrenal responses to stress: the linking of type A behavior pattern to ischemic heart disease

This report is an analysis of the findings of blood pressure, pulse rate, adrenergic and noradrenergic responses to laboratory and clinical stresses in subjects according to Type A and Type B behavior patterns. Thirty-three experiments of Type A - B cardiovascular and sympathoadrenal responses to a variety of laboratory stressors were identified. Twenty-nine of these were analyzed and the data of 20 were pooled to give mean values for the percentage increments of systolic and diastolic blood pressures, pulse rates, and plasma levels of NE and E for Type A vs B patients respectively; (15 +/- 2 vs 10 +/- 1, P less than .05; 13 +/- 1 vs 8 +/- 1, P less than .02; 19 +/- 2 vs 13 +/- 2, P less than .05, 60 +/- 11 vs 19 +/- 8, P less than .02; and 106 +/- 45 vs 23 +/- 12, P less than .1). Seventy-five percent of the analyzed experiments provided evidence for heightened cardiovascular and sympathoadrenal responsivity in Type A subjects. NE and E appear to be hormonal intermediates which play a lethal role in ischemic heart disease. Neutralization of neural tone may be an important goal in the therapy of hypertensives with Type A behavior pattern.