Type a Behavior Pattern as a Risk Factor for Coronary Heart Diseases

Abstract

This is a study of type A behavior pattern in patients with coronary heart diseases (CHD). Type A behavior pattern (coronary-prone behavior pattern) has been recognized as a risk factor for CHD in western countries. Three hundred patietns with new onset of CHD (243 cases of acute myocardial infarction and 57 cases of unstable angina pectoris) between 1981 and 1987 were analysed from the standpoint of behavior pattern. Type A behavior pattern assessed by Jenkins Activity Survey (JAS) was found in 64.6% of subjects and in 43.0% of healthy controls (p<0.05). Concerning occupational position, the majority of patients in the administrative class showed type A behavior pattern. Type A behavior pattern was not related with other traditional risk factors (hypertension, hypercholesterolemia and smoking) and was related with angiographically documented severity of coronary atherosclerosis. Emotional stress load by mirror drawing test (MDT) evoked more elevation of blood pressure and plasma catecholamine level in type A patients than in type B patients. A follow-up of post CHD patietns, whose occupational position belonged to the administrative class and/or whose work load did not decrease after CHD, modification of type A behavior pattern seemed to be difficult. In conclusion, we consider that type A behavior pattern exists also in Japanese CHD patients, and plays an important role in the development of CHD. © 1990, The Japanese Circulation Society. All rights reserved.