Table 1.
Studies of type A behaviour, hostility, and coronary heart disease. References in this table are given on the BMJ website
| Author, year, country | Total sample (% women) | Age at entry | Exposure | Follow up (years) | No of events | Type of events | Adjustments | Relative risk* | Summary† |
|---|---|---|---|---|---|---|---|---|---|
| Prospective aetiological studies | |||||||||
| Jenkins 1974w1 USA | 2750 (0) | 39-59 | Type A | 4 | 120 | Non-fatal MI + angina | Age | 1.8* | + |
| Rosenman 1976w2 USA | 3154 (0) | 39-59 | Type A | 8.5 | 257 | Fatal CHD + non-fatal MI | Age, smoking, cholesterol, family history, corneal arcus, schooling, β:α lipoprotein ratio | 2.16* | ++ |
| Haynes 1980w3 USA | 1674 (57) | 45-77 | Type A (Framingham) | 8 | 170 | Fatal CHD + non-fatal MI + coronary insufficiency + angina | Age, smoking, blood pressure, cholesterol, glucose intolerance and other psychosocial factors | 1.8*; among men, the effect was confined to white collar workers | + |
| Shekelle 1983w4 USA | 1877 (0) | 40-55 | Hostility (MMPI) | 10 | 139 | Fatal CHD + non-fatal MI | Age, smoking, blood pressure, cholesterol, alcohol | 1.47*, but effect not linear | + |
| Cohen 1985w5 USA | 2187 (0) | 57.8 (mean) | Type A (JAS) | 8 | 190 | Fatal CHD + non-fatal MI + angina | Smoking, blood pressure, cholesterol, body mass index, alcohol, and other biological factors | 1.43, Type A associated with prevalence, not incidence or postmortem findings | 0 |
| Shekelle 1985w6 USA | 3110 (0) | 46 (mean) | Type A (JAS) | 7.1 | 554 | Fatal CHD + non-fatal MI | Age, smoking, blood pressure, cholesterol, alcohol, education | 0.87 | 0 |
| Johnston 1987w7 UK | 5936 (0) | 40-59 | Type A (Bortner) | 6.2 | 255 | Fatal CHD + non-fatal MI | Age, social class | 0.89 | 0 |
| Ragland 1988w8 USA | 3154 (0) | 39-59 | Type A (SI) | 22 | 214 | Fatal CHD | Age, smoking, blood pressure, cholesterol | 0.98 | 0 |
| Hearn 1989w9 USA | 1399 (0) | 19 | Hostility (MMPI) | 33 | 54 | Fatal CHD + non-fatal MI + angina + coronary surgery | Smoking, hypertension, family history | 1.1; no association in crude or risk factor adjusted analyses | 0 |
| Barefoot 1995w10 USA | 730 (44) | 50 | Hostility (Cook-Medley) | 27 | 122 | Non-fatal MI | Age, sex, smoking, blood pressure, triglycerides, exercise | 1.26 (men) 2.95* (women) | 0 (men) ++(women) |
| Bosma 1995w11 Lithuania and Netherlands | 5817 (0) | 45-60 | Type A (JAS) | 9.5 | 394 | Fatal CHD + non-fatal MI | Age | No association | 0 |
| Kawachi 1996w12 USA | 1305 (0) | 40-90 | MMPI-2 anger content scale | 7 | 110 | Fatal CHD + non-fatal MI + angina | Age, smoking, blood pressure, cholesterol, body mass index, family history, alcohol | 2.66* | ++ |
| Everson 1997w13 Finland | 1599 (0) | 42-60 | Cynical hostility (Cook-Medley) | 6 | 60 | First MI | Age, biological, socioeconomic, behavioural, social support, prevalent diseases | 1.43 (2.18* when adjusted for age only) | 0 |
| Tunstall-Pedoe 1997w14 Scotland | 11659 (50) | 40-59 | Type A (Bortner) | 7.6 | 581 | Fatal CHD + non-fatal MI + coronary surgery | Age | 0.82* in women, ie type A protective | 0 |
| Prognostic studies | |||||||||
| Case 1985w15 USA | 516 (18) patients <14 days post MI | <70 | Type A (JAS) | 2 | 53 | Fatal CHD and all cause mortality | Age, sex, education, rales, ejection fraction, New York Heart Assocation functional class, ventricular premature beats | 0.8 | 0 |
| Shekelle 1985w16 USA | 2314 (11) patients post MI | 30-69 | Type A (JAS) | 3 | 294 | Non-fatal MI and fatal CHD | Smoking, previous MI, angina, fasting glucose | No association | 0 |
| Ragland 1988w17 USA | 257 (0) with MI or angina | 39-70 | Type A (SI) | 11.5 | 91 | Fatal CHD | Age at initial event, follow up time, type of initial coronary event, smoking, blood pressure, cholesterol | 0.58*; type A protective | 0 |
| Barefoot 1989w18 USA | 1467 (18) patients with angiographic disease | mean 52 (SD 9) | Type A (SI) | 5 | 315 | Fatal CVD + non-fatal MI | Stratified on clinical prognostic factors | No association with non-fatal MI | 0 |
| Jenkinson 1993w19 UK | 1376 (22) 7 days post-MI | 25-84 | Type A | 3 | 247 | All cause mortality | Age, previous MI,hospital complications, diabetes, hypertension, car ownership, sex | No association | 0 |
CHD=coronary heart disease; MI=myocardial infarction; SI=structured interview; JAS=Jenkins activity survey; MMPI=Minnesota multiphasic personality inventory.
*
P<0.05. †0=no association—that is, relative risk not significantly different from unity; +=moderate association (relative risk >1⩽2.0); ++=strong association (relative risk >2.0).