Coronary-prone behavior pattern and cardiovascular response in persons with and without coronary heart disease.

The purpose of this investigation was to examine the psychophysiologic responses of Type A and Type B individuals, among persons with and without coronary heart disease (CHD). Subjects were 58 adult male volunteers; 24 had a history of myocardial infarction or clinically diagnosed angina pectoris (CHD) and 34 had been designated free of coronary disease following recent cardiologic examination (non-CHD). All subjects had normotensive resting blood pressures; among CHD patients, no subject was currently on beta-adrenergic blocking medication. Measures of heart rate (HR) and systolic and diastolic blood pressure (SBP, DBP) were obtained during a baseline period and while subjects performed a series of difficult and frustrating cognitive tasks. Each subject was also administered the Structured Interview for Type A--Type B assessment (SI) and the Jenkins Activity Survey (JAS). Results indicated that, independent of the A/B typology, CHD patients experienced significantly greater DBP elevations during the experimental tasks than did non-CHD controls. Type A subjects (as determined by the SI) exhibited greater task-related increases in SBP and DBP than did Type Bs, but changes in HR did not differ between these two groups. Type A--Type B assessments based on the JAS were unrelated to subjects SBP, DBP, or HR responses, and neither SI- nor JAS-defined Type As differed reliably from Type Bs on measures of task performance. Overall, these results are consistent with the hypothesis that heightened cardiovascular reactivity under stress may mediate relationships between behavioral factors and CHD.