(Circulation. 1998;98:405.)
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports |
Prospective Study of a Self-Report Type A Scale and Risk of Coronary Heart Disease
Test of the MMPI-2 Type A Scale
From the Department of Health and Social Behavior, Harvard School of Public Health, and Channing Laboratory, Harvard Medical School (I.K., L.D.K.); Normative Aging Study, Department of Veterans Affairs Outpatient Clinic (D.S., A.S., P.S.V.); Boston University School of Public Health (A.S.), and Section of Preventive Medicine and Epidemiology and Evans Memorial Department of Clinical Research, Department of Medicine, Boston Medical Center, Boston University School of Medicine (P.S.V.); Channing Laboratory, Brigham and Women’s Hospital (I.K., S.T.W.); and Pulmonary and Critical Care Division, Beth Israel Hospital and Harvard Medical School (S.T.W.), Boston, Mass.
Correspondence to Dr I. Kawachi, Department of Health and Social Behavior, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115. E-mail ichiro.kawachi{at}channing.harvard.edu
Background—Several methods exist by which to assess type A behavior (TAB). Although the videotaped clinical interview is regarded as the "gold standard," self-report measures have also proved useful in assessing TAB in large population studies. The purpose of this study was to examine prospectively the relationship of TAB to risk of coronary heart disease (CHD) incidence with the use of the revised Minnesota Multiphasic Personality Inventory (MMPI-2) Type A Scale. To the best of our knowledge, this is the first test of this scale in the context of predicting CHD incidence.
Methods and Results—The study was performed in the VA Normative Aging Study, an ongoing cohort of older (mean age, 61 years) community-dwelling men. A total of 1305 men who were free of diagnosed CHD in 1986 completed the MMPI-2 Type A Scale. During an average 7.0 years of follow-up, 110 cases of incident CHD occurred. Compared with men in the lowest quartile of type A scores, men in the highest quartile had multivariate adjusted relative risks of 2.86 (95% CI, 1.19 to 6.89; P for trend=0.016) for combined CHD death and nonfatal myocardial infarction (MI) and 2.30 (95% CI, 1.32 to 4.01; P for trend=0.001) for combined CHD death/nonfatal MI plus angina pectoris. The relationship of TAB to CHD was independent of measures of anger and cynicism.
Conclusions—The MMPI-2 Type A Scale predicts CHD incidence. Further research is warranted to examine the correlation, if any, between this scale and the videotaped clinical interview.
Key Words: coronary disease • type A personality • hostility • anger
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