Type A Behavior and Risk of All-Cause Mortality, CAD, and CAD-Related Mortality in a Type 1 Diabetic Population: 22 Years of Follow-up in the Pittsburgh Epidemiology of Diabetes Complications Study

Abstract

OBJECTIVETo determine whether type A behavior predicts all-cause mortality and incident coronary artery disease (CAD) in a type 1 diabetic population.RESEARCH DESIGN AND METHODSFollow-up data (22 years) from the Pittsburgh Epidemiology of Diabetes Complications (EDC) study of childhood-onset type 1 diabetes were analyzed for the 506 participants who completed the Bortner Rating Scale (measuring type A behavior) and Beck Depression Inventory (BDI) at baseline (1986–1988). CAD comprised myocardial infarction as determined by hospital records/Q waves on electrocardiogram (ECG), CAD death (determined by a mortality classification committee), angiographic stenosis, ischemic ECG, and angina.RESULTSThere were 128 deaths (25.3%) during follow-up. Univariate analysis showed an inverse relationship between Bortner scores and all-cause mortality (P = 0.01), which remained significant after allowing for age, sex, duration, HbA1c, education, smoking, BMI, and physical activity (P = 0.03). However, the addition of BDI scores attenuated the relationship (P = 0.11) with a significant interaction (P = 0.03) such that any protective effect against mortality was limited among individuals with lower BDI scores (bottom three quintiles) (P = 0.07), whereas no effect was seen in those with higher BDI scores (P = 0.97). Bortner scores showed only a borderline association with incident CAD (P = 0.09).CONCLUSIONSThose with higher type A behavior have lower all-cause mortality in our type 1 diabetic population, an effect that interacts with depressive symptomatology such that it is only operative in those with low BDI scores. Further research should focus on understanding this interaction.

Potential influence of Type A personality on plasma C-reactive protein levels in people with diabetes

“…Fickley et al [4] revealed that, in type 1 diabetes, cardiac and all-cause mortality rates were lower in people with Type A personality. The present study is therefore consistent with the Fickley report, and suggests that Type A might be associated with reduced mortality through lower levels of systemic inflammation in patients with diabetes.…”

“…In the context of chronic diseases, Type A personality was even associated with increased survival in people with coronary heart disease [1]. Also, Type A was recently associated with lower cardiovascular and all-cause mortality in type 1 diabetes [4]. It is worth mentioning that the association between Type A personality and lower mortality in patients with diabetes [4] was found with the Bortner Type A rating scale, which captures time urgency, job involvement and competitiveness dimensions, but not hostility.…”

“…Also, Type A was recently associated with lower cardiovascular and all-cause mortality in type 1 diabetes [4]. It is worth mentioning that the association between Type A personality and lower mortality in patients with diabetes [4] was found with the Bortner Type A rating scale, which captures time urgency, job involvement and competitiveness dimensions, but not hostility. However, the psychobiological processes underlying the improved prognosis in Type A people with chronic disease remain unknown.…”

“…As Type A is linked with specific personality dimensions such as conscientiousness [6,7], optimism [10] and positive engagement coping [11], which are associated with both lower levels of inflammation and better clinical outcomes in diabetes [4], the present study postulated that lower plasma CRP levels would be associated with Type A personality among patients with diabetes.…”

Prevalence of dental caries based on personality types of 35–44 years old residents in Davangere city

“…Many studies have established the relationship of personality of an individual as risk factor of heart diseases, cancer, injuries and mental disorders. 2,3 People with Type A personality traits are aggressive, ambitious, highly competitive, preoccupied with status, workaholics, hostile, and lack patience and traits of Type B personality are relaxed, less stressed, flexible, emotional and expressive, and have a laid-back attitude. The personality of the Type C or ''anger in'' personality is described as a repressive and vigilant personality pattern.…”