By Tim Friend
USA TODAY

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 an artery.

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 says.

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.