Objectives: To evaluate whether the pathogenesis of type A behavior may involve the premature development of coronary atherosclerosis.
Background: Type A or coronary-prone behavior is considered a possible risk factor for the development of coronary heart disease. Premature development of coronary atherosclerosis is suspected to play a role.
Thirteen of 32 patients with coronary heart disease who also exhibited symptoms and signs of severe time urgency and hostility (the two overt components of type A behavior [TAB]) were found to exhibit multiple episodes of silent myocardial ischemia over a 48-hour period of Holter monitoring as indicated by electrocardiogram ST depressions. Ten of these 13 patients were given 14 months of TAB counseling in an attempt to diminish the intensity of their time urgency and hostility. The remaining three patients served as controls.
View Article and Find Full Text PDFCardiac disability ratings in workers' compensation cases currently lack any consistent scientific basis, with varying medical evidence used by different examiners in the same case. Opinions about the extent of disability may differ with the same patient, delaying resolution and the delivery of benefits. We describe guidelines for determining cardiac impairment and suggest a schedule for rating disability based on evidence.
View Article and Find Full Text PDFThree hundred post infarction participants who had received type A behavioral counseling in the Recurrent Coronary Prevention Project, (RCPP) agreed to be followed for 1 additional year after stopping 4.5 years of continuous type A behavioral counseling. One hundred fourteen participants who had served for 4.
View Article and Find Full Text PDFOne thousand thirteen post myocardial infarction patients were observed for 4.5 years to determine whether their type A (coronary-prone) behavior could be altered and the effect such alteration might have on the subsequent cardiac morbidity and mortality rates of these individuals. Eight hundred sixty-two of these individuals were randomly assigned either to a control section of 270 participants who received group cardiac counseling or an experimental section of 592 participants who received both group cardiac counseling and type A behavioral counseling.
View Article and Find Full Text PDFEight hundred sixty-two postmyocardial infarction patients volunteered to be randomly selected and enrolled into: (1) a control section of 270 patients, who received group cardiologic counseling; and (2) an experimental section of 592 patients, who received group type A behavior counseling in addition to group cardiologic counseling. Reduction in type A behavior at the end of 3 years was observed in 43.8% of the 592 participants, who initially were enrolled to receive group cardiologic and type A behavioral counseling.
View Article and Find Full Text PDFWe studied 1035 consecutive postinfarction patients to determine the feasibility of altering type A behavior and the effect such alteration might have on subsequent rates of infarction and cardiovascular death. Approximately 300 subjects were enrolled in small groups and primarily received cardiologic counseling on the usually accepted coronary risk factors. Six hundred subjects received, in addition to cardiologic counseling, advice and instructions designed to diminish the intensity of their type A behavior.
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