The discovery of the Type A personality and its link to coronary heart disease (CHD) is a famed story. Described by cardiologists Meyer Friedman and Ray Rosenman in the 1950s, Type A behaviour -- impatient, hostile, and striving – increases the risk of heart disease. It was an important connection initially identified by their upholsterer:
“[Friedman] … had this cardiology practice in San Francisco—everything was going great. They had this one problem, though. For some reason, they were wearing out chairs in the waiting room at an incredibly high rate.... Every month this upholsterer comes in, fixes a chair or two. One month the upholsterer is on vacation. A replacement upholsterer comes in, takes one look at the chairs and discovers type A personality. He says, ‘What is wrong with your patients? Nobody wears out chairs this way.”
The Type A behaviour pattern / personality with chronic stress offers an increased risk for developing CHD – more than high cholesterol, smoking or being overweight according to the Framingham Heart Study. In part of this long term study, a psychosocial questionnaire was given to 1674 CHD free individuals who were followed for 8 years: “Women who developed CHD scored significantly higher in Type A behaviour, suppressed hostility (not showing or discussing anger), tension and anxiety symptoms than women remaining free of CHD.”
Chronic stressful behaviour appears to amplify other risk factors for CHD:
Comparing the relative predictive accuracy for death from cancer and death from CHD of smoking, blood pressure, and blood cholesterol, all taken together, with personality type, it was found that (1) personality type was six times as important as a risk factor as were the other variables, and (2) the interaction of all these variables was synergistic.
Efforts to mitigate this risk may include behaviour modification therapy and other forms of stress reduction, mindfulness, nutrition and supplementation.
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