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Persons eligible for membership in this personality genre generally exhibit a familiar composite of behaviors that may include aggression, competitiveness, a strong need to excel, impatience, hard-driving, hostility, achievement-orientation, and quick to anger. Historically, these attributes have collectively been viewed as a recipe for cardiovascular disaster, particularly when combined with the physiologic risks just mentioned. In much the same way that later research distinguished between "good" and "bad" cholesterol, however, there is some support for the contention that we also need to distinguish between good (or at least okay) and bad type A personality. As a result, not all facets of type A behavior need to be arrested by the personality police.
A study recently published by Yan et al1 found that competitive, achievement-striving people do not increase their risk of developing hypertension (a common precursor of myocardial infarction, coronary artery disease, and stroke) unless they are also impatient or hostile. In contrast to many other studies in this area that have examined only a single aspect of the type A profile at a time, Yan’s research investigated all of the main components of type A behavior simultaneously. Other salient comparative features of this study are that it examined possible relationships between psychosocial factors and development of cardiovascular disease in a large (rather than small) sample, of young (rather than middle-age) adults, over a long (rather than short) period, prospectively (rather than retrospectively), and in multiple (rather than a single) sites. More specifically, the study explored the association of psychosocial factors on the 15-year risk of developing hypertension (systolic = 140 mm Hg, diastolic = 90 mm Hg) among 3308 black and white adults, aged 18 to 30 years, from 4 US metropolitan areas. Another important finding from this work was that the long-term risk of developing hypertension was directly and incrementally associated with increasingly higher levels of hostility or impatience; that is, the more impatient and/or the more hostile, the greater the risk of becoming hypertensive.
The good news here is that those of us who admit to harboring a number of those classical type A personality traits can breathe a sigh (albeit swift and shallow) of relief that we are not necessarily condemned to a life abbreviated by temperamental indiscretions. Our "whatever it takes" demeanor should not, in itself, be the genesis of our demise. The bad news is that these findings were identified in a large pool of young people who, on the basis of age alone, would not be considered as high risk for developing hypertension at all. In light of other recent findings related to escalating incidences of obesity, lack of exercise, and diabetes among those who have barely reached puberty, however, the results of this study suggest that yet another risk factor for cardiovascular disease needs to be included in critical care patient assessments, interventions, education, and discharge planning.
Critical care nurses might incorporate the findings of this study in much the same way as these variables were explored with study participants—that is, by asking patients a few questions that reflect each of this problematic duo:
Impatience (time urgency)
Hostility
Just think of the possibilities here: Rather than being subjected to endless television commercials showing excited middle-aged people bragging about how they lowered their bad cholesterol levels, we could look forward to endless commercials displaying calm young people bragging about how they eradicated road rage (job rage, air rage, parking lot rage, and the like) from their lives. I can hardly wait (patiently, of course)!
Reference
This article has been cited by other articles:
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  K. Carroll Mentoring: A Human Becoming Perspective Nurs Sci Q, October 1, 2004; 17(4): 318 - 322. [Abstract] [PDF]
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