Hecker M H, Chesney M A, Black G W, Frautschi N
Department of Behavioral Medicine, SRI International, Menlo Park, California.
Psychosom Med. 1988 Mar-Apr;50(2):153-64. doi: 10.1097/00006842-198803000-00005.
Two-hundred-fifty CHD cases and 500 matched controls from the Western Collaborative Group Study were studied to assess the 8.5-yr prospective relationship of specific behavioral dimensions to the incidence of coronary heart disease. Type A structured interviews administered at intake were reevaluated in terms of 12 operationally defined components, which include previously described facets of the Type A behavior pattern. Univariate risk analyses using the matched logistic model found hostility (RR = 1.92, p less than 0.001), speaking rate (RR = 1.66, p = 0.003), immediateness (RR = 1.62, p = 0.009), competitiveness (RR = 1.50, p = 0.013), and Type A content (RR = 1.38, p = 0.045) to be significantly related to CHD incidence. Of these, only hostility remained a significant risk factor (RR = 1.93, p less than 0.001) when all 12 components were included in the model. The original Type A global ratings and traditional CHD risk factors were also analyzed in conjunction with the components. The Type A behavior pattern comprises both benign and coronary-prone facets, with the latter most exemplified by hostility.
对来自西方协作组研究的250例冠心病患者和500例匹配的对照者进行了研究,以评估特定行为维度与冠心病发病率之间8.5年的前瞻性关系。对入组时进行的A型结构化访谈,根据12个可操作性定义的组成部分进行重新评估,其中包括先前描述的A型行为模式的各个方面。使用匹配逻辑模型进行的单变量风险分析发现,敌意(相对风险=1.92,p<0.001)、说话速度(相对风险=1.66,p=0.003)、即刻性(相对风险=1.62,p=0.009)、竞争性(相对风险=1.50,p=0.013)和A型内容(相对风险=1.38,p=0.045)与冠心病发病率显著相关。其中,当模型中纳入所有12个组成部分时,只有敌意仍然是一个显著的风险因素(相对风险=1.93,p<0.001)。还结合这些组成部分对原始的A型总体评分和传统冠心病风险因素进行了分析。A型行为模式包括良性和易患冠心病的方面,后者最典型的表现是敌意。