The Relationship of Psychosocial Factors to Coronary Heart Disease in the Framingham Study

Abstract

In a cross-sectional study of 1822 persons aged 45 to 77 years of age, the association of 20 psychosocial scales with coronary heart disease (CHD) prevalence was assessed. Women (aged 45 to 64 years) with coronary disease scored significantly higher on the Framingham Type A behavior, emotional lability, aging worries, tension, and anger symptoms scales than women free of CHD. The prevalence of CHD was significantly higher among working women and housewives classified as Type A than as Type B behavior. Among men under 65 years, Framingham Type A behavior, aging worries, daily stress, and tension were associated with the prevalence of myocardial infarction (MI). For men and women over 65 years, marital dissatisfactions or disagreements were significantly related to the prevalence of CHD. In a multivariate analysis, the above associations were controlled for age, blood pressure, cholesterol, smoking, and other psychosocial scales. Among women under 65 years of age, Framingham Type A behavior and emotional lability remained significant discriminators of CHD prevalence. Aging worries significantly differentiated men under 65 with and without MI. Issues related to the interpretation of results from cross-sectional studies are discussed, and four hypotheses are suggested for future prospective work in this area.

Stress in Middle-Aged Women: Influence of Type A Behavior and Narcissism

“…It would be desirable for them to be aware of the burden imposed on them by stress. Ac cording to the Framingham study [4,5], type A behavior was more prominent in wom en who worked outside their home than in full-time housewives, and the effects of workrelated type A behavior were not inconsidera ble. They also reported that working women under stress were characterized by emotional instability and were affected by stressors un related to their duties on the job [4,5], The results of this study also indicate that type A behavior is stronger in working women than in nonworking women although the differ ence is not significant.…”

“…Cor onary artery disease (CAD) is often seen in middle-aged men, and working is closely re lated to stress and to type A behavior [8,9]. Therefore, in research of the relationship be tween CAD and stress the subjects are often working men, and only a very small amount of survey research, including the Framingham study [4,5], has been done on women. None theless, because women also suffer from CAD and because recently the number of women who work outside the home has been increas ing, the importance of research on type A behavior and women cannot be denied.…”

Type A personality and mortality: Competitiveness but not speed is associated with increased risk

“…Early investigations of the association between TABP and CVD indicated a positive relationship with CVD incidence (2)(3)(4)(5)(6). Furthermore, it was shown that the clinical outcome of CHD was improved in patients undergoing behavioral counseling (7,8).…”

Effects of acute psychological stress on adhesion molecules, interleukins and sex hormones: implications for coronary heart disease

“…Psychological stress and stressful life events are risk factors for coronary heart disease (CHD) and myocardial infarction (MI), the main cause of death in industrialized countries (Haynes et al 1978). In an animal model, socially stressed adult male cynomolgus monkeys (Macaca fascicularis) developed more extensive coronary artery atherosclerosis than unstressed controls (Kaplan et al 1983).…”