Can the type A behavior pattern be altered after myocardial infarction? A second year report from the recurrent coronary prevention project.

The feasibility of altering a Type A style of life was investigated in 1012 nonsmoking predominantly male postinfarction volunteers in the San Francisco Bay area. A total of 862 were randomly allocated into an experimental section receiving a combination of Type A and cardiac counseling, or a control section receiving cardiac counseling alone. The remaining 150 formed a nonrandom but statistically equivalent comparison section. Assessments of change in Type A behavior were made by the participant, his or her spouse, a work colleague, and an independent rater of a videotaped structured interview. Psychometric analyses indicated that these instruments were valid and reliable measures of Type A behavior. After 24 months, participants receiving Type A/cardiac counseling exhibited a significantly greater reduction in Type A behavior than the other two sections, and had a lower cardiovascular recurrence rate than the comparison section only. No differences among the three sections were observed in total cholesterol or resting blood pressure. The results suggest that Type A behavior can be altered by group counseling in postinfarction volunteers and that such alteration is superior to no group counseling at all in the secondary prevention of coronary heart disease.