August 19, 2009

Personality Plays Role in Surviving Peripheral Artery Disease

A preliminary study suggests that a negative, inhibited personality type (type D personality) appears to predict an increased risk of death among patients with peripheral arterial disease (PAD), according to a new report.

Peripheral arterial disease occurs when plaque builds up in arteries that supply blood to areas other than the heart and brain -- such as the extremities.

Patients with PAD also have an increased risk of stroke, heart attack and death. "Preliminary evidence suggests that personality traits such as hostility may also be associated with the severity and progression of atherosclerosis [plaque buildup] in patients with PAD," the authors wrote. "Another potential individual risk factor in this context is the distressed personality type (type D). Type D refers to the joint tendency to experience negative emotions and to inhibit self-expression in social interaction."

Annelies E. Aquarius, Ph.D., of Tilburg University in the Netherlands and colleagues studied 184 patients, average age 64.8, with peripheral arterial disease between 2001 and 2004. Participants completed a personality questionnaire to assess their degree of negativity and social inhibition when they enrolled in the study. They were asked to rate certain statements such as 'I often find myself worrying about something,' or 'I would rather keep people at a distance,' as true or false on a scale of zero to four.
During four years of follow-up, 16 patients died, including seven who died of cancer and six of cardiovascular disease. After adjusting for age, sex, diabetes and kidney disease, patients with type D personality had increased risk of death.

Authors noted that the type D personality has been associated with increased activation of the immune system and changes in the body's stress response system.

"In addition to improving awareness of the traditional medical risk factors in peripheral arterial disease, attention should be given to psychological factors that may have an adverse effect on the clinical course of peripheral arterial disease," the authors concluded. "The present findings show that screening for type D personality may be especially important in this context."

SOURCE: Archives of Surgery, August 2009