It has been found that the traditional indicators of heart disease such as smoking, high cholesterol and high blood pressure account for about 50% of heart attacks. In trying to account for the rest the focus has moved to psychosocial factors - personality and behavior which give rise to stress hormones, chronic stress, Type A personality, anger, depression and social isolation not only have a direct negative effect on the cardiovascular system but they also increase the effects of other cardiac risk factors.

Chronic stress

Chronic stress is a common theme in modern living. Most people do not have sufficient time for their overcommitted, busy work and family lives. Uncontrolled stress has a significant effect on heart health. It:

increases heart rate and blood pressure,
increases cholesterol and homocysteine levels,
increases artery wall inflammation,
constricts the arteries which can result in a heart attack,
creates heart rhythm irregularities - which can trigger a sudden cardiac death and
increases blood clotting.

As well as these adverse factors people who are under stress tend to eat "fast food" which is often high in fat, lead sedentary lives, drink a lot of caffeine and smoke. If their weight increases so do their triglycerides and body mass index and this increases their chances of getting diabetes. There is a significant peak in the numbers of heart attacks that occur between 7 and 10 o'clock on a Monday morning. The number of heart attacks is low on Saturdays.

Personality types

Type A personality makes people prone to heart disease. It is characterised by hard driving, competitive people who feel they have to do everything themselves. They are involved in a struggle to get more and more done in less and less time, often against perceived opposition of either people or things. They make up about 50% of the population and are five to seven times more likely to have a heart attack than the more relaxed Type B personalities. It is believed that some particular components of the Type A personality are more closely linked to heart disease. These are anger and hostility. Research has recently started to look at the Type D personality - the "distressed" personality. The Type D person has negative feelings about virtually everything. It has been known for some time that negative emotions particularly depression significantly increase the risk of developing heart disease while lowering the long term survival of heart patients. However, new studies suggests that the pessimistic people, the negative thinkers - those who worry over trivial, every day events - are four times more likely to have a heart attack than more positive thinkers. There are a number of tests that have been developed to asses the propensity for Type A personality. The following is adapted from Pistcatella and Frankin (2003).

Read each of the statements below and grade yourself on how you would respond to each situation using the following scale.

1 = never, 2 = seldom, 3 = sometimes, 4 = usually, 5 = always

I become angry when I stand in line for more than 15 minutes.
I handle more than one problem at a time.
It's hard to find the time to relax and unwind during the day.
I become irritated and annoyed when someone speaks too slowly.
I try hard to win at sports and games.
I have trouble doing special things for myself.
I work much better when I am under pressure or have to meet a deadline.
When I loose at sports or games, I get angry with myself and or with others.
I find myself looking at my watch when I am sitting around and not active.
I bring work home with me.
I feel energised and exhilarated after being in a pressure situation.
I feel like I need to take charge in order to get things done.
I find myself eating quickly regardless of whether I have time to eat slowly or not.
I do things quickly regardless of whether I have time to do them slowly or not.
I interrupt what people are saying when I think they are wrong.
I'm inflexible and rigid when it comes to changes at work or at home.
I become jittery and need to move whenever I'm trying to relax.
I find myself eating faster than the people I am eating with.
At work I do more than one task at a time in order to feel productive.
I take less vacation time than I am entitled to.
I find myself being very picky and looking at the small details
I become annoyed at people who do not work as hard as I do.
I find that there aren't enough things to do during the day.
I spend a good deal of time thinking about my work.
I get bored very easily.
I'm active on weekend either doing work or projects.
I get into arguments with people who don't think my way.
I have trouble "going with the flow" whenever problems arise.
I interrupt someone's conversation in order to speed things up.
I take everything I do seriously.
100 to 150 points Type A personality

76 to 99 points Type A/B

30 to 75 points Type B

Scores of 90 or above are associated with a greater risk of heart problems.

Are you at increased risk? If you are then you need to take action. Develop a more relaxed attitude and routine -- I know (as a once upon a time Type A personality myself) that this is more easily said than done. However, there are some simple things that can help. These include making time each day to actually do some regular exercise and in particular using a relaxation audio as a way to calm down at the end of the day (or at any time that you are feeling stressed). These are particularly important -- but they are only the start of the adjustments that you may need to make.

References

Aesoph, L. 2001, 6 Steps for Handling Stress, Health World Online. June 2001.

Pistcatella, J.C. and Frankin, B.A. 2003, Take a Load off Your Heart. Workman.

Oberman, A. 2000, Emerging Cardiovascular Risk Factors. Clinical Reviews. Spring 2000.

Dr Jenny Tylee is an experienced health professional who is passionate about health and wellbeing. She believes that health is not just absence of disease and seeks to actively promote vitality and wellness through empowering others. encourages people to improve their health by quit smoking (Growerz.com can assist with becoming smoke free), cleansing their body, taking essential, non-contaminated vitamin and mineral supplements and many other methods, including herbal remedies. Join her free newsletter for more valuable health information.