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Type A behavior pattern and coronary atherosclerosis
Insights
The Type A behavior pattern, characterized by competitiveness and hostility, is linked to more severe coronary atherosclerosis. This association persists even when accounting for traditional risk factors like age and cholesterol.
Area of Science:
- Cardiology
- Psychosomatic Medicine
- Behavioral Medicine
Background:
- Previous studies linked Type A behavior pattern to increased clinical coronary heart disease (CHD) events.
- The relationship between Type A behavior and the underlying coronary atherosclerotic process required further investigation.
Purpose of the Study:
- To determine if the association between Type A behavior and CHD extends to the coronary atherosclerotic process.
- To assess the correlation between behavior patterns and the severity of coronary atherosclerosis.
Main Methods:
- 156 patients undergoing coronary angiography were assessed using a structured interview for behavior pattern (Type A, Type B, Type X).
- Coronary atherosclerosis severity was evaluated, and traditional risk factors (age, sex, cholesterol, smoking) were recorded.
Main Results:
- Traditional risk factors like age, sex, cholesterol, and smoking correlated with atherosclerotic disease.
- Type A patients showed increasing proportions with moderate to severe coronary occlusions.
- This association remained significant after controlling for traditional risk factors.
Conclusions:
- Behavior pattern Type A independently contributes to the risk of coronary heart disease.
- Type A behavior may influence the atherosclerotic process, increasing the risk of clinical CHD events.
Abstract:
Previous research has demonstrated an increased rate of clinical coronary heart disease (CHD) events among people who exhibit a "coronary prone" (Type A) behavior pattern. This study was undertaken to determine whether the association between behavior pattern Type A and CHD might be extended beyond clinical CHD events to include also the coronary atherosclerotic process. In addition to usual clinical evaluation, 156 consecutive patients referred for diagnostic coronary angiography were independently assessed on the basis of a structured interview and assigned a rating of Type A, Type B, or Type X (indeterminate). Traditional physiologic factors--age, sex, cholesterol and cigarette smoking--were found to correlate with atherosclerotic disease. Type A patients were found in increasing proportions among groups of patients with coronary occlusions of moderate to severe degree compared with patients with only mild occlusions. This increasing proportion of Type A patients with increasing disease severity remained significant, even when age, sex, blood pressure, serum cholesterol level and cigarette smoking history were all simultaneously covaried. These findings suggest that, independently of traditional risk factors, behavior pattern Type A may contribute to the risk of clinical CHD events via effects on the atherosclerotic process.