September 20, 2010

Type D Personality & Heart Risk

(Ivanhoe Newswire) -- Heart patients with "distressed" (Type D) personality profile may face a higher risk of cardiovascular problems.

The personality classification system that identified "Type A" decades ago, more recently defined Type D as a personality marked by chronic negative emotions, pessimism and social inhibition. Researchers noted a three-fold increased risk of cardiovascular issues such as peripheral artery disease, angioplasty or bypass procedures, heart failure, heart transplantation, heart attack or death for Type D heart patients.Screening heart patients for such personality traits could give doctors the chance to intervene early with psychological or behavioral counseling and perhaps improve cardiovascular outcomes.

"Type D patients tend to experience increased levels of anxiety, irritation and depressed mood across situations and time, while not sharing these emotions with others because of fear of disapproval," senior author Viola Spek, Ph.D., researcher at Tiburg University in the Netherlands, was quoted as saying. "We found that Type D personality predicts mortality and morbidity in these patients, independent of traditional medical risk factors."

Researchers analyzed 49 studies of Type D personality and future heart health or psychological health. A Type D profile was also linked to a three-fold increase in long-term risk of psychological conditions including clinical depression, anxiety or poor mental health.

"Type D personality and depression are distinct manifestations of psychological distress, with independent cardiovascular effects," lead author Johan Denollet, Ph.D., was quoted as saying. "Our findings support the simultaneous use of depression and Type D measures to flag high-risk patients."

The alphabetic personality classification scheme dates to the recognition of the Type A behavior pattern decades ago, the scientists noted. Other types followed, and the Type D framework arose in the 1990s. Findings have been mixed regarding whether the Type A profile, probably the best known, is associated with worse cardiovascular outcomes. Traits that define Type A include competitiveness, a focus on achievement, a sense of urgency and hostility.

Type D is associated with differences in cortisol, a stress hormone that can temporarily increase blood pressure. It also may be related to elevated levels of inflammation. Type D patients appear to respond differently to cardiovascular stress, and they may be less likely to get regular medical checkups or communicate effectively with their physicians.

SOURCE:  Circulation: Cardiovascular Quality and Outcomes, September 19, 2010.