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American Journal of Epidemiology Vol. 122, No. 4: 559-570
Copyright © 1985 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
THE MRFIT BEHAVIOR PATTERN STUDY
II. TYPE A BEHAVIOR AND INCIDENCE OF CORONARY HEART DISEASE
1School of Public Health, University of Texas Houston, TX
2Department of Epidemiology and International Health, University of California School of Medicine San Francisco, CA
3Division of Biometry, University of Minnesota School of Public Health Minneapolis, MN
4Medical Research Institute San Francisco, CA
5Department of Community Health, University of California School of Medicine Davis, CA
6Department of Epidemiology and Public Health, University of Miami School of Medicine Miami, FL
7Division of Epidemiology, University of Minnesota School of Public Health Minneapolis, MN
8New Jersey Medical School Newark, NJ
9Department of Community Health and Preventive Medicine, Northwestern University School of Medicine Chicago, IL
Reprint requests to Dr. James D. Neaton, MRFIT Coordinating Center, Suite 508, 2829 University Avenue, SE, Minneapolis, MN 55414
Behavior pattern was assessed by interview for 3,110 men at eight centers in the Multiple Risk Factor Intervention Trial (1973–1976). The Type A pattern was not significantly associated with risk of first major coronary events (coronary death and definite nonfatal myocardial infarction) after a mean follow-up of 7.1 years. Crude relative risks for Types A1–A2 versus X-B were 1.08 in usual care, 0.82 in special intervention, and 0.92 overall. Adjustment for age, blood pressure, cigarette smoking, serum cholesterol, consumption of alcohol, and educational attainment yielded relative risks of 0.99 in usual care, 0.81 in special intervention, and 0.87 overall (95% confidence interval = 0.59–1.28). The Jenkins Activity Survey Type A score, obtained for 12,772 men at all 22 centers, was also not significantly associated with risk of first major coronary events. Overall, crude risks in the lowest (Type B) through highest (Type A) quintiles of the score's distribution were 5.0%, 4.4%, 4.0%, 4.3%, and 4.1%, respectively. The proportional hazards regression coefficient, adjusted for the variables listed above, was –0.006 (95% confidence interval = –0.015–0.003). These results raise questions regarding the robustness of the Type A hypothesis in its present form. Further studies are needed to investigate these questions and to evaluate the validity of procedures used to assess behavior patterns.
coronary disease; psychological tests; psychology; stress
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