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Stressful life events, Type A behavior, and the prediction of cardiovascular and total mortality over six years

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Abstract

The relationships between stressful life events and subsequent mortality and morbidity were determined prospectively over 6 years for 12,866 men participating in the Multiple Risk Factor Intervention Trial (MRFIT). Also evaluated was the impact of life events on cardiovascular outcomes for persons exhibiting and not exhibiting coronary prone (Type A) behavior. Subjects completed life events checklists at baseline and each of five annual visits. Participants were also administered the Jenkins Activity Survey measure of Type A behavior at baseline and a subsample of 3110 participants was categorized as to behavior type based on the structured interview assessment method. Cox proportional hazard analyses indicated that number of life events experienced during each of 6 years of follow-up was unrelated to risk in the subsequent year of CHD death or fatal plus nonfatal MI and was inversely related to total mortality. The impact of life events on cardiovascular risk did not differ by behavior type category.

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References

  • Benfari, R. C. (1981). The Multiple Risk Factor Trial (MRFIT) III. The model for intervention.Prev. Med. 10: 426–442.

    Google Scholar 

  • Billings, A. G., and Moos, R. H. (1982). Stressful life events and symptoms: A longitudinal model.Health Psychol. 1: 99–117.

    Google Scholar 

  • Case, R. B., Heller, S. S., Case, N. B., and Moos, A. J. (1985). Multicenter Post-Infarction Research Group. Type A behavior and survival after acute myocardial infarction.N. Engl. J. Med. 312: 737–741.

    Google Scholar 

  • Cox, D. R., and Oakes, D. C. (1984).Analysis of Survival Data, Chapman and Hall, London.

    Google Scholar 

  • Dembroski, T. M., and Costa, P. (1987). Coronary-prone behavior: Components of the Type A pattern and hostility.J. Personal. 55: 311–226.

    Google Scholar 

  • Dohrenwend, B. S., and Dohrenwend, B. P. (eds.) (1974).Stressful Life Events: Their Nature and Effects, Wiley, New York.

    Google Scholar 

  • Dohrenwend, B. S., and Dohrenwend, B. P. (eds.) (1981).Stressful Life Events and Their Contexts, Prodist, New York.

    Google Scholar 

  • Glass, D. C. (1977).Behavior Patterns, Stress, and Coronary Disease, Lawrence Erlbaum Assoc., Hillsdale, NJ.

    Google Scholar 

  • Goldberg, E. L., and Comstock, G. W. (1976). Life events and subsequent illness.Am. J. Epidemiol. 104: 146–158.

    Google Scholar 

  • Gunderson, E. K. E., and Rahe, R. H. (eds.), (1974).Life Stress and Illness, Thomas, Springfield, Ill.

    Google Scholar 

  • Haney, C. A. (1980). Life events as precursors of coronary heart disease.Soc. Sci. Med. 14A: 119–126.

    Google Scholar 

  • Jenkins, C. D., Rosenman, R. H., and Friedman, M. (1967). Development of an objective psychological test for the determination of the coronary-prone behavior pattern in employed men.J. Chron. Dis. 20: 371–379.

    Google Scholar 

  • Jenkins, C. D., Zyzanski, S. J., and Rosenman, R. H. (1971). Progress toward validation of a computer-scored test for the Type A coronary-prone behavior pattern.Psychosom. Med. 33: 193–202.

    Google Scholar 

  • Kallifleisch, J. L., and Prentice, R. L. (1981).The Statistical Analysis of Failure Time Data, John Wiley & Sons, New York.

    Google Scholar 

  • Kasl, S. V. (1984). Stress and health.Am. Rev. Publ. Health 5: 319–341.

    Google Scholar 

  • Kobasa, S. C., Maddi, S. R., and Courington, S. (1981). Personality and constitution as mediators in the stress-illness relationship.J. Health Soc. Behav. 22: 368–378.

    Google Scholar 

  • Matthews, K. A., Glass, D. C., Rosenman, R. H., and Bortner, R. W. (1977). Competitive drive, pattern A, and coronary heart disease: A further analysis of some data from the Western Collaborative Group Study.J. Chron. Dis. 30: 489–498.

    Google Scholar 

  • McFarlane, A. H., Norman, G. R., Streiner, D. L., and Roy, R. G. (1983). The process of social stress: Stable, reciprocal, and mediating relationships.J. Health Soc. Behav. 24: 160–173.

    Google Scholar 

  • Mechanic, D. (1972). Social psychologic factors affecting the presentation of bodily complaints.N. Engl. J. Med. 286: 1132–1139.

    Google Scholar 

  • Mechanic, D., and Volkart, E. H. (1961). Stress, illness behavior, and the sick role.Am. Sociol. Rev. 26: 51–58.

    Google Scholar 

  • The Multiple Risk Factor Intervention Trial Group (1977). Statistical design considerations in the NHLBI Multiple Risk Factor Intervention Trial (MRFIT).J. Chron. Dis. 30: 261–275.

    Google Scholar 

  • The Multiple Risk Factor Intervention Trial Group (1979). The MRFIT Behavior Pattern Study. I. Study design, procedures, and reproducibility of behavior pattern judgments.J. Chron. Dis. 32: 293–305.

    Google Scholar 

  • The Multiple Risk Factor Intervention Trial Group (1982). Multiple Risk Factor Intervention Trial: Risk factor changes and mortality results.JAMA 248: 1465–1477.

    Google Scholar 

  • National Center for Health Statistics (1966). Weight by Height and Age of Adults, 1960–1962.Vital and Health Statistics, PHS Publ. No. 1000-Series 11-No. 14, U.S. Government Printing Office, Washington, DC.

    Google Scholar 

  • Prineas, R. J., Crow, R. S., and Blackburn, H. (1982).The Minnesota Code Manual of Electrocardiographic Findings, John Wright-PSG, Boston.

    Google Scholar 

  • Ragland, D. R., and Brand, R. J. (1988). Type A behavior and mortality from coronary heart disease.N. Engl. J. Med. 318: 65–69.

    Google Scholar 

  • Rahe, R. H., and Arthur, R. J. (1978). Life change and illness studies: Past history and future directions.J. Hum. Stress 41: 147–164.

    Google Scholar 

  • Review Panel on Coronary-Prone Behavior and Coronary Heart Disease (1981). Coronary-prone behavior and coronary heart disease: A critical review.Circulation 63: 1199–1215.

    Google Scholar 

  • Rosenman, R. H., Friedman, M., Straus, R., Wurm, M., Kositchek, R., Hahn, W., and Werathessen, N. T. (1964). A predictive study of coronary heart disease: The Western Collaborative Group Study.JAMA 189: 103–110.

    Google Scholar 

  • Ruberman, W., Weinblatt, E., Goldberg, J. D., and Chaudhary, B. S. (1984). Psychosocial influences on mortality after myocardial infarction.N. Engl. J. Med. 311: 552–559.

    Google Scholar 

  • Rundall, T. G. (1978). Life change and recovery from surgery.J. Health Soc. Behav. 19: 418–427.

    Google Scholar 

  • Scherwitz, L., Graham, L. E., Grandits, G., and Billings, J. (1987). Speech characteristics and coronary heart disease incidence in the Multiple Risk Factor Intervention Trial.J. Behav. Med. 10: 173–195.

    Google Scholar 

  • Shekelle, R. B., Hulley, S. B., Neaton, J. D., Billings, J., Borhani, N. O., Gerace, T. A., Jacobs, D., Lasser, N., Mittlemark, M., and Stamler, J. (1985). The MRFIT behavior pattern study II. Type A behavior and incidence of coronary heart disease.Am. J. Epidemiol. 122: 559–570.

    Google Scholar 

  • Sherwin, R., Kaelber, C. T., Kezdi, P., Kjelsberg, M. O., and Thomas, H. E., Jr. (1981). The Multiple Risk Factor Intervention Trial (MRFIT) II. The development of the protocol.Prev. Med. 10: 402–425.

    Google Scholar 

  • Suls, J., and Sanders, G. S. (1988). Type A behavior as a general risk factor for physical disorder.J. Behav. Med. 11: 201–226.

    Google Scholar 

  • Theorell, T., Lind, E., and Floderus, B. (1975). The relationship of disturbing life changes and emotions to the early development of myocardial infaction and other serious illnesses.Int. J. Epidemiol. 4: 281–293.

    Google Scholar 

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Hollis, J.F., Connett, J.E., Stevens, V.J. et al. Stressful life events, Type A behavior, and the prediction of cardiovascular and total mortality over six years. J Behav Med 13, 263–280 (1990). https://doi.org/10.1007/BF00846834

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