Coronary-Prone Behavior and Cardiovascular Reactivity

This study has been completed.
Sponsor:
Information provided by:
National Heart, Lung, and Blood Institute (NHLBI)
ClinicalTrials.gov Identifier:
NCT00005144
First received: May 25, 2000
Last updated: June 23, 2005
Last verified: April 2000
  Purpose

To further clarify the concept of coronary-prone behavior and to develop methods of assessing coronary-prone behavior. Specifically, to revise the component scoring system for Potential for Hostility in the Structured Interviews measure of Type A behavior.


Condition
Cardiovascular Diseases
Coronary Disease
Heart Diseases

Study Type: Observational

Resource links provided by NLM:


Further study details as provided by National Heart, Lung, and Blood Institute (NHLBI):

Study Start Date: August 1978
Estimated Study Completion Date: December 1990
  Hide Detailed Description

Detailed Description:

BACKGROUND:

In 1978, a select Review Panel of biomedical and behavioral scientists met under the auspices of the NIH to evaluate the data linking the Type A behavior pattern to coronary heart disease. Based on the scientific evidence available to them in December, 1978, the members of the Panel issued a report in which they concluded that the Type A behavior pattern was an independent risk factor for coronary heart disease, of a magnitude similar to that of other established risk factors, such as cigarette smoking and serum cholesterol.

At the time the Panel met, the most impressive evidence linking the Type A behavior pattern to coronary heart disease was the prospective Western Collaborative Group Study (WCGS), which established a significant risk ratio for Structured Interview-assessed Type A behavior pattern for all clinical manifestations of coronary heart disease; and three angiographic studies which reported significant associations between Structured Interview-defined Type A behavior pattern and severity of coronary artery disease. Supporting evidence was provided by prevalence studies employing the Jenkins Activity Survey (JAS) measure of Type A behavior pattern, and by incidence and prevalence data from the Framingham study, using a six-item scale thought to assess aspects of Type A behavior.

Subsequent to the conference, studies had begun to emerge which called into question the robustness of the association between the Type A behavior pattern and various manifestations of coronary heart disease. The most damaging of these was the prospective Type A study included in MRFIT. In this study, 3,110 men were given the Structured Interview and Jenkins Activity Survey, and followed for an average period of seven years, while receiving annual medical examinations. Analysis of the results at the end of the seven years revealed that Type A behavior pattern, however assessed, was completely unrelated to either coronary death or documented myocardial infarction.

A major tool was the component scoring system for the Structured Interview to determine which of the many attributes comprising the multidimensional Type A behavior pattern were actually associated with coronary heart disease. Component scoring had demonstrated that some components had consistent associations with coronary heart disease, even when the global Type A behavior pattern showed no relationship. Component analysis of the Type A behavior pattern in MRFIT revealed that of all the attributes assessed, only Potential for Hostility was significantly related to incidence of coronary heart disease. Several other studies were conducted under this project. Tape-recorded Structured Interviews from the Western Collaborative Group Study were reanalyzed to assess the relationship between components of Type A behavior and incidence of coronary heart disease. Rescoring was completed on Structured Interviews of over 1,000 subjects who had undergone stress testing while blood pressure and heart rate were recorded. An analysis was also conducted on the influence of cigarette smoking and situational stress on cardiovascular response in young male subjects.

DESIGN NARRATIVE:

In Study I, tape-recorded Structured Interviews from MRFIT were re-scored for Potential for Hostility. In Study II, Structured Interviews were obtained from a new sample of participants in the BLSA. In the BLSA the Structured Interview were expanded to include questions that dealt more directly and sampled more fully antagonistic self-descriptions, attitudes, and behaviors. Alternative measures of Agreeableness-Antagonism were already available from the BLSA sample that were used to validate scores from the expanded Structured Interview, and biomedical information on BLSA participants was used to further test the predictive utility of Antagonistic Hostility as a risk factor for coronary heart disease. Previous research had scored Potential for Hostility from the Structured Interview by examining Content, Intensity, and Style as well as a clinical judgement of Total Potential for Hostility. In the present study, Antagonistic Hostility was measured in terms of Antagonistic Style and Self-Descriptions. A total score was defined as the sum of these two components. Antagonistic Style was scored using a 5-point scale when rudeness, condescension, and disagreeableness were expressed toward the interviewer. Matched and unmatched logistic regressions were used to evaluate Antagonistic Hostility as a risk factor for morbidity and mortality outcomes. Multivariate analyses were used to control for other standard risk factors.

  Eligibility

Genders Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

No eligibility criteria

  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

No Contacts or Locations Provided
  More Information

Publications:
Dembroski TM, MacDougall JM: Stress and Cigarette Smoking: Implications for Cardiovascular Risk. In: Schmidt TH, Dembroski TM, Blumchen G (Eds), Biological and Psychological Factors in Cardiovascular Disease. New York, Springer Verlag. pp 246-257, 1986
Dembroski TM: Overview of Classic and Stress-Related Risk Factors: Relationship to Substance Effects on Reactivity. Matthews KA et al (Eds), Handbook of Stress, Reactivity, and Cardiovascular Disease. New York, Wiley, pp 275-289, 1986
Dembroski TM, MacDougall JM, Williams RB: Reply to Professor Steptoe. Psychosom Med, 5:371-373, 1986
Matthews KA, Weiss S, Detre T, Dembroski TM, Faulkner B, Manuck S, Williams RB (Eds): Handbook of Stress, Reactivity, and Cardiovascular Disease. New York, Wiley, 1986
Schmidt TH, Dembroski TM, Blumchen G (Eds): Biological and Psychological Factors in Cardiovascular Disease. New York, Springer Verlag, 1986
Costa PT, et al: Hostility, Agreeableness-Antagonism and Coronary Heart Disease. J Holistic Med, 1987
Dembroski TM, MacDougall JM, Herd JA, Shields JL: Effects of Level of Challenge on Pressor and Heart Rate Responses in Type A and B Subjects. J Appl Social Psychol, 9:209-228, 1979
Dembroski TM: Cardiovascular Reactivity in Type A Coronary-Prone Subjects. In: Oborne DJ, Gruneberg M, Eiser J, (Eds.) Research in Psychology and Medicine, New York: Academic Press, 1979
Streufert S, Streufert S, Dembroski TM, MacDougall JM: Complexity, Coronary-Prone Behavior, and Physiological Response. In: Oborne DJ, Gruneberg M, Eiser J, (Eds.) Research in Psychology and Medicine, New York: Academic Press, 1979
Dembroski TM: Behavior Patterns, Stress, and Coronary Disease. Biofeedback and Self-Regulation. (Review), 5:125-130, 1980
Dembroski TM: Coronary-Prone Behavior: An Example of a Current Development in Behavioral Medicine. Natl Forum, 60:5-9, 1980
Dembroski TM, MacDougall JM, Herd JA, Shields JL: The Type A Coronary-Prone Behavior Pattern: A Review. Technical Report, National Heart, Lung and Blood Institute, National Institutes of Health, 1980
Dembroski TM, Halhuber M (Eds.) Psychosocial Stress and Coronary Heart Disease. Berlin: Springer-Verlag, 1980
Dembroski TM: Physiological and Behavioral Concomitants of the Type A Pattern, In: Dembroski TM, Halhuber M (Eds.) Psychosocial Stress and Coronary Heart Disease. Berlin: Springer-Verlag, 1980
Dembroski TM, MacDougall JM, Herd JA, Shields JL: Coronary-Prone Behavior: An Appraisal and Evaluation. In: Dembroski TM, Halhuber M (Eds.) Psychosocial Stress and Coronary Heart Disease. Berlin: Springer-Verlag, 1980
Dembroski TM, MacDougall JM: Coronary-Prone Behavior, Social Psycho-Physiology, and Coronary Heart Disease. In: Eiser JR (Ed) Social Psychology and Behavioral Medicine. London: Wiley, 1980
Dembroski TM, Wiliams RB. Assessment of Coronary-Prone Behavior. In: Schneidermann, et al (Eds), Handbook of Research Methods in Cardiovascular Behavioral Medicine. New York: Plenum Press, 1989
Costa PT, McCrae RR, Dembroski TM: Agreeableness vs. Antagonism: Explication of a Potential Risk Factor for CHD. In Siegman A, Dembroski T (Eds), In Search of Coronary-Prone Behavior. Hillsdale, NJ: Lawrence Erlbaum, 1989.
Dembroski TM, Czajkowski S: Historical and Current Developments in Coronary-Prone Behavior. In: Siegman A, Dembroski T (Eds), In Search of Coronary-Prone Behavior. Hillsdale, NJ, Lawrence Erlbaum, 1989.
Siegman AW, Dembroski TM (Ed): In Search of Coronary-Prone Behavior. Hillsdale NJ, Lawrence Erlbaum, 1989.
Schmidt TM, Undeutsch K, Dembroski TM, Hahn R, Langosh W, Neus H, Ruddel H: Kardiovaskullaere Risikofaktoren und Typ-A-Verhalten. Verhandlung Der Deutschen Geselschaft Fuer Innere Medizin, 88, 1204-1209, 1982
Dembroski TM, MacDougall JM: Coronary-Prone Behavior, Social Psychophysiology, and Coronary Heart Disease. In: Eiser JR (Ed) Social Psychology and Behavioral Medicine. London, Wiley, 1982
Eliot RS, Dembroski TM: Getting to the Heart of Coronary-Prone Behavior. Colloquy, July, 5-7, 1982
Dembroski TM: Behavior and Cardiovascular Response Measurement Through Ambulatory Monitoring. Technical Report, Behavioral Medicine Branch, National Heart, Lung, and Blood Institute, July 1982
Dembroski TM, Schmidt T, Blumchen G: (Eds.) Biobehavioral Bases of Coronary Heart Disease. New York, Karger, 1983
Dembroski TM, MacDougall JM, Eliot RS, Buell JC: A Social-Psychophysiological Model of Biobehavioral Factors and Coronary Heart Disease. In: Spielberger CD, Sarason IG, Defares PB, Stress and Anxiety, Vol. 9, New York, Hemisphere, 1983
Dembroski TM, MacDougall JM, Eliot RS, Buell JC: Stress, Emotions, Behavior, and Cardiovascular Disease. In: Temoshok L, Van Dyke C & Zegans LS (Eds.) Emotions in Health and Illness. San Diego, Grune & Stratton, 1983
Dembroski TM, MacDougall JM: Validation of the Vita-Stat Automated Noninvasive Ambulatory Blood Pressure Recording Device. In: J. A. Herd & S. Weiss (Eds.) Cardiovascular Instrumentation: Applicability of New Technology to Biobehavioral Research. Bethesda, MD: NIH Publication No 84-1654, March 1984
Musante L, MacDougall JM, Dembroski TM: Type A Behavior Pattern and Attributions for Success and Failure. Pers Soc Psychol Bulletin, 10:544-553, 1984
Dembroski TM: Stress and Substance Interaction Effects on Risk Factors and Reactivity. Behav Med Update, 6:16-20, 1984
Dembroski TM: Stress-Substance Interaction and Reactivity. In: Weiss S, Matthews K, Detre T, Graeff J (Eds), Stress, Reactivity, and Cardiovascular Disease. Bethesda, Maryland: NIH Publication No 84-2698, 1984
Dembroski TM, MacDougall JM: Beyond Global Type A: Relationship of Paralinguistic Attributes, Hostility, and Anger-In to Coronary Heart Disease. In: Field T, McCabe P, Schneiderian N (Eds), Stress and Coping, Hillsdale, New Jersey, Lawrence Erlbaum. pp 223-242, 1985
Schmidt TH, Dembroski TM, MacDougall JM, Ledig P, Eschweiler J, Thrierse H: Various Perspectives on Cardiovascular Reactivity and the Type A Behavior Pattern. In: Orlebeke J, Mulder G, Van Doornen L (Eds), Psychophysiology of Cardiovascular Control: Models, Methods, and Data. London, Plenum. pp 733-743, 1985

ClinicalTrials.gov Identifier: NCT00005144     History of Changes
Other Study ID Numbers: 1015
Study First Received: May 25, 2000
Last Updated: June 23, 2005
Health Authority: United States: Federal Government

Additional relevant MeSH terms:
Cardiovascular Diseases
Coronary Disease
Coronary Artery Disease
Heart Diseases
Myocardial Ischemia
Vascular Diseases
Arteriosclerosis
Arterial Occlusive Diseases

ClinicalTrials.gov processed this record on July 23, 2014