Can the Type A Behavior Pattern be Altered after Myocardial Infarction? A Second Year Report from the Recurrent Coronary Prevention Project

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Abstract
The feasibility of altering a type A style of life was investigated in 1012 nonsmoking predominantly male postinfarction volunteers in the San Francisco Bay [California, USA] area. A total of 862 were randomly allocated into an experimental section receiving a combination of type A and cardiac counseling or a control section receiving cardiac counseling alone. The remaining 150 formed a nonrandom but statistically equivalent comparison section. Assessments of change in type A behavior were made by the participant, his or her spouse, a work colleague and an independent rater of a videotaped structured interview. Psychometric analyses indicated that these instruments were valid and reliable measures of type A behavior. After 24 mo., participants receiving type A/cardiac counseling exhibited a significantly greater reduction in type A behavior than the other 2 sections, and had a lower cardiovascular recurrence rate than the comparison section only. No differences among the 3 sections were observed in total cholesterol or resting blood pressure. Type A behavior possibly can be altered by group counseling in postinfarction volunteers and such alteration may be superior to no group counseling at all in the secondary prevention of coronary heart disease.