Are specific components of the Type A behavior pattern associated with coronary disease severity in patients with CAD?
Hostility and internalized anger, rather than global Type A personality, are the specific psychosocial factors associated with increased severity of coronary artery disease.
Previous research has linked the Type A coronary-prone behavior pattern to angiographically documented severity of coronary atherosclerosis (CAD). The present study sought through component scoring of the Type A Structured Interview (SI) to determine what elements of the multidimensional Type A pattern are related to coronary disease severity in a selected group of patients with minimal or severe CAD. Multivariate analyses controlling for the major risk factors showed no relationship between global Type A and extent of disease. Of all attributes measured, only Potential for Hostility and Anger-In were significantly and positively associated with the disease severity, including angina symptoms and number of myocardial infarctions. Further analysis revealed that Potential for Hostility and Anger-In were interactive in their association, such that Potential for Hostility was associated with disease endpoints only for patients who were high on the Anger-In dimension. These findings support previous research in suggesting that anger and hostility may be the critical aspects of the Type A pattern in predisposing individuals to risk of CAD.
Dembroski et al. (1985) studied this question.