6D • TUESDAY, AUGUST 13 1996 • USA TODAY
PLUS REPORTS ON THE SCIENCES AND ENVIROMENT
Temper may play into repeat angioplasties
|By Tim Friend
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
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.