Temper, temper. New research on men undergoing balloon
angioplasty suggests being a type A jerk more than doubles
the risk of needing a second or third procedure.
Balloon angioplasty is an effective alternative to bypass
surgery for many people with less severe blockages in
their coronary arteries. But more than a third of people
must have a second procedure within six months to reopen
This complication, called restenosis, has been studied
intensely, but its cause remains a mystery and preventing
it is an unmet challenge.
The new study, in the August Mayo Clinic Proceedings,
is the first to link hostility to an increased risk for
restenosis, says Mark Goodman, who conducted
the research at Union Memorial Hospital, Baltimore.
Goodman, a behavioral medicine specialist,
observed the link after cardiologists began sending him
their most difficult Type A patients
for stress reduction training. Type A’s are impatient
and hyperactive. Hostile Type A’s have the added
feature of being angry, nasty and hard to get along with.
“A colleague would call and say, ‘This person
is a real handful, can you calm him down?’ Then
I noticed these people were the same ones that kept coming
back for repeat angioplasty,” Goodman
Goodman and colleagues studied 41 angioplasty
patients and determined their personality types. Patients
who were deemed hostile Type A’s were 2.5 times
more likely to undergo repeat angioplasty.
Other studies of hostile Type A’s show they have
higher levels of adrenaline and stress hormones in their
blood that make their vessels more likely to constrict.
Keeping arteries bathed in stress hormones also may accelerate
the formation of new blockages.
Goodman says the next step is to determine
whether teaching hostile angioplasty patients to mellow
out will reduce their risk of repeated procedures.