If you’re a classic “Type A” personality—hard-driving, impatient, competitive, intense, easily irritated—you are far more likely than a calm, laid-back “Type B” to suffer a heart attack, right?
Wrong, says a Massachusetts General Hospital psychiatrist who has studied more than 200 heart patients awaiting diagnostic① tests and found virtually no correlation② between classic Type A personalities and subsequent heart disease.
What does appear to be a predictor of serious heart trouble—in conjunction with other known risk factors such as smoking, high blood pressure and high cholesterol—says Dr. Joel E. Dimsdale, director of the MGH Stress Physiology Laboratory, is a chronic inability to deal constructively with anger and hostility③. He is now doing a study on anger and heart disease.
“The whole Type A theory is a lovely theory that has been controversial from Day One,” says Dimsdale. “There’s undoubtedly some validity to it but trying to piece together exactly what constitutes the virulence of Type A and for what: people, that’s the rub”.
Type A is a very broad concept that comprises a host of many different personality and behavioral factors. The real research task today is to search for the way in which specific behaviors might increase the risks for specific patients. And a number of studies are showing that people who readily experience hostility but who have difficulty expressing it are at increased risk for coronary④ artery disease. This dimension is a better predictor for various cardiac end points than the gross measure of Type A.
The original insight that people could be classified into Type A and Type B personalities and that Type A’s were more heart-attack prone grew out of research at the Framingham Heart Study Laboratories in the late 1970s.
Dr. Peter Wilson, director of the Framingham laboratories, agreed that, “the AB” issue has been getting weaker. A large prospective study (in which people are followed for years before they get sick) showed the A—B behavior distinction was not associated with coronary artery disease. Now researchers are thinking in terms of “anger in” vs. “anger out” as the latest area of concern.
Elaine Eaker agreed in principle. She said there is no epidemiological evidence on hostility alone, but anger has been linked to CHD ［coronary heart disease］ events, weakly for white collar men and more strongly for women in clerical⑤ jobs.
The Type A concept is still viable because it has been a predictor of heart disease in at least two long-term studies. But recent research has shown that how you cope with anger may be the new coronary prone behavior of the future. And it’s tough to cope with anger.
Since holding anger inside may lead to heart trouble and since acting it out by having temper tantrums is highly antisocial, Faker says researchers now advocate⑥ maturely “discussing” anger—either with the person who makes you angry or with a friend—as the most constructive method of dealing with explosive feelings.
Since the early Type A studies, researchers have been attempting to fine-tune the ways in which they can identify a person as Type A or Type B, not an easy task since people often deny or are actually unaware of some facts of their personalities and hence can not be asked point-blank if they are angry or impatient by nature.
