Is Type A Behavior Really a Trigger for Coronary Heart Disease Events?

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Abstract
The purpose of this study was to compare chronic with acute mechanisms by which Type A might predict incident coronary heart disease (CHD). The study included 2394 men aged 50 to 64 years who were assessed for CHD, Type A behavior, and CHD risk factors. Type A was assessed using the Jenkins Activity Survey (JAS), the Bortner scale, and the Framingham scale. Further examinations were completed at 5 and 9 years for incident CHD. After 9 years, there was no increased risk of CHD associated with any Type A score. Nevertheless, high Bortner scores were associated with increased risk of incident CHD at 5 years and high JAS and Bortner scores were associated with a decreased risk between 5 and 9 years. Further analysis of Type A scores on time to first coronary event found strong inverse associations for all type A scores (JAS = 205 −0.49 months to first event, 95% CI = −0.20, −0.78, p = .001) (Bortner = 176 −0.27 months; 95% CI = −0.10, −0.44;p = .002) (Framingham = 0.44 −0.0011 months; 95% CI = −0.0002, −0.0019;p = .01). The data show Type A is a strong predictor of when incident coronary heart disease (or coronary event) will occur rather than if it will occur. These findings suggest that Type A increases exposure to potential triggers, rather than materially affecting the process of atherosclerosis.