The Framingham Type A Behaviour Pattern and Coronary Heart Disease in Three Countries: A Cross-Cultural Comparison

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Abstract
The Framingham Type A behaviour pattern (TABP), a risk factor for cardiovascular disease mortality, was examined in a cross-cultural study involving three countries known to differ in cardiovascular disease mortality, namely Germany, Lithuania and Northern Ireland. The factorial structure of the Frarningham TABP scale was strikingly similar in the three countries, with three factors (work pressure, hard driving, and impatience) identified; evidence for the cross-cultural validity of the scale. Scores on all three factors showed considerable variation between the three populations for both men (multivariate P < 0.0001) and women (multivariate P < 0.0001). Of particular note, on the two factors, hard driv ing and impatience, thought to be core pathogenic elements in the TABP complex, Lithuanian and Northern Irish males and females scored substantially higher than their German counterparts. These cross-cultural variations in levels of risk are discussed in the context of the different ischaemic heart disease mortality rates in the three countries.

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