Prediction of Clinical Coronary Heart Disease by a Test for the Coronary-Prone Behavior Pattern

Prospective study of 2750 employed men who completed a computer-scored test questionnaire measuring the coronary-prone Type A behavior pattern showed that high scorers had twice the incidence of new coronary heart disease as low scorers over a four-year period. Subjects with different initial clinical manifestations of coronary disease did not differ from one another in their Type A test scores. The double-blind design of these studies and the orderly relation of Type A scores to coronary-disease risk suggest that the coronary-prone behavior pattern is prospectively linked to the pathogenesis of coronary heart disease. The findings also indicate that the test questionnaire used is a valid means of measuring some of the ways in which behavior contributes to coronary risk. (N Engl J Med 290:1271–1275, 1974)