Coronary-prone behavior pattern and cardiovascular response in persons with and without coronary heart disease
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Coronary heart disease (CHD) patients show greater blood pressure increases during stress. Type A individuals also exhibit higher blood pressure reactivity, suggesting a link between stress response and heart health.
Area of Science:
- Cardiology
- Psychophysiology
- Behavioral Medicine
Background:
- Type A and Type B behavior patterns are studied in relation to coronary heart disease (CHD).
- Cardiovascular reactivity to stress is a potential mediator between behavior and CHD.
Purpose of the Study:
- To investigate psychophysiological responses in Type A and Type B individuals with and without coronary heart disease (CHD).
- To examine the relationship between behavioral patterns, cardiovascular reactivity, and existing CHD.
Main Methods:
- 58 adult males (24 with CHD, 34 without) underwent cognitive tasks measuring heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP).
- Subjects completed the Structured Interview for Type A--Type B assessment (SI) and the Jenkins Activity Survey (JAS).
Main Results:
- CHD patients showed significantly greater diastolic blood pressure (DBP) elevations than non-CHD controls during tasks.
- Type A individuals (SI-defined) had greater task-related increases in SBP and DBP compared to Type Bs.
- Jenkins Activity Survey (JAS) assessments did not correlate with cardiovascular responses or task performance.
Conclusions:
- Heightened cardiovascular reactivity under stress may link behavioral factors to CHD.
- The Structured Interview (SI) appears more sensitive than the Jenkins Activity Survey (JAS) in identifying behavior-related cardiovascular responses.
Abstract:
The purpose of this investigation was to examine the psychophysiologic responses of Type A and Type B individuals, among persons with and without coronary heart disease (CHD). Subjects were 58 adult male volunteers; 24 had a history of myocardial infarction or clinically diagnosed angina pectoris (CHD) and 34 had been designated free of coronary disease following recent cardiologic examination (non-CHD). All subjects had normotensive resting blood pressures; among CHD patients, no subject was currently on beta-adrenergic blocking medication. Measures of heart rate (HR) and systolic and diastolic blood pressure (SBP, DBP) were obtained during a baseline period and while subjects performed a series of difficult and frustrating cognitive tasks. Each subject was also administered the Structured Interview for Type A--Type B assessment (SI) and the Jenkins Activity Survey (JAS). Results indicated that, independent of the A/B typology, CHD patients experienced significantly greater DBP elevations during the experimental tasks than did non-CHD controls. Type A subjects (as determined by the SI) exhibited greater task-related increases in SBP and DBP than did Type Bs, but changes in HR did not differ between these two groups. Type A--Type B assessments based on the JAS were unrelated to subjects SBP, DBP, or HR responses, and neither SI- nor JAS-defined Type As differed reliably from Type Bs on measures of task performance. Overall, these results are consistent with the hypothesis that heightened cardiovascular reactivity under stress may mediate relationships between behavioral factors and CHD.