Journal of Behavioral Medicine

, Volume 13, Issue 1, pp 1–13 | Cite as

Type A behavior and its association with cardiovascular disease prevalence in Blacks and Whites: The Minnesota heart survey

  • J. Michael Sprafka
  • Aaron R. Folsom
  • Gregory L. Burke
  • Lorraine P. Hahn
  • Phyllis Pirie


Population-based surveys were conducted in 1985 and 1986 to measure the prevalence of coronary heart disease (CHD) history and risk factors in Black and White adults. Type A behavior was measured by the Jenkins Activity Survey (JAS). JAS scores were associated with age (negatively), education (positively), and sex (men>women) but were largely unrelated to CHD risk factors. Blacks had significantly lower age- and education-adjusted Type A and component scores than Whites, more so formen than women. Univariate analysis indicated that a history of angina and/or heart attack was positively associated with the Type A score in both Blacks and Whites. Following adjustment for known cardiovascular risk factors, Type A score remained positively and significantly associated with CHD prevalence. These findings are consistent with other cross-sectional studies and suggest that Type A behavior, as measured by the JAS, may increase the risk of CHD in both Blacks and Whites. Follow-up of these cohorts may help to clarify the complex relationship of Type A behavior to the risk of CHD.

Key words

Black Americans cardiovascular disease Jenkins Activity Survey prevalence Type A pattern 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Cohen, J. B., and Reed, D. (1985). The Type A behavior pattern and coronary heart disease among Japanese men in Hawaii.J. Behav. Med. 8: 343–352.PubMedGoogle Scholar
  2. DeBacker, G., Kornitzer, M., Kittel, F., and Dramaix, M. (1983). Behavior, stress and psychosocial traits as risk factors.Prev. Med. 12: 32–36.PubMedGoogle Scholar
  3. Dembroski, T. M. (1978). Reliability and validity of methods used to assess coronary-prone behavior. In Dembroski, T. M., Weiss, S. M., Shields, T. L.,et al. (eds.),Coronary Prone Behavior, Springer-Verlag, New York, pp. 95–106.Google Scholar
  4. Dimsdale, J. E., Hackett, T. P., Hutter, A. M.,et al. (1978). Type A personality and extent of coronary atherosclerosis.Am. J. Cardiol. 42: 583–586.PubMedGoogle Scholar
  5. Gillum, R. F. (1982). Coronary heart disease in black populations. I. Mortality and morbidity.Am. Heart J. 104: 839–851.PubMedGoogle Scholar
  6. Haynes, S. G., Levine, S., and Scotch, N. (1978). The relationship of psychosocial factors to coronary heart disease in the Framingham Study. I. Methods and risk factors.Am. J. Epidemiol. 107: 362–383.PubMedGoogle Scholar
  7. Haynes, S. G., Feinlieb, M., and Kannel, W. B. (1980). The relationship of psychosocial factors to coronary heart disease in the Framingham Study. III. Eight year incidence of coronary heart disease.Am. J. Epidemiol. 111: 37–58.PubMedGoogle Scholar
  8. Jenkins, C. D. (1983). Psychosocial and behavioral factors. In Kaplan, N. M., and Stamler, J., (eds.),Prevention of coronary Heart Disease: Practical Management of the Risk Factors, W. B. Saunders, Philadelphia, pp. 98–118.Google Scholar
  9. Jenkins, C. D., Zyzanski, S. J., and Rosenman, R. H. (1979).Jenkins Activity Survey, Psychological Corporation.Google Scholar
  10. Johnson, D. W., and Shaper, A. G. (1983). Type A behavior in British men: Reliability and intercorrelation of two measures.J. Chron. Dis. 36: 203–207.PubMedGoogle Scholar
  11. Luepker, R. V., Jacobs, D. R., Gillum, R. F.,et al. (1985). Population risk of cardiovascular disease. The Minnesota Heart Survey.J. Chron. Dis. 38: 671–682.PubMedGoogle Scholar
  12. Lipid Research Clinics Program (1974).Manual on Laboratory Operations, DHEW Publication NIH 75-628, NHLBI, NIH, Bethesda, Md.Google Scholar
  13. Matthews, K. A., and Haynes, S. G. (1986). Type A behavior pattern and coronary disease risk. Update and critical evaluation.Am. J. Epidemiol. 123: 923–960.PubMedGoogle Scholar
  14. Ragland, D. R., and Brand, R. J. (1988). Type A behavior and mortality from coronary heart disease.N. Engl. J. Med. 381: 65–69.Google Scholar
  15. Rose, G. A., Blackburn, H., Gillum, R. F., and Prineas, R. J. (1982).Cardiovascular Survey Methods, 2nd ed., World Health Organization, Geneva.Google Scholar
  16. Rosenman, R. H. (1978). The interview method of assessment of the coronary-prone behavior pattern. In Dembroski, T. M., Weiss, S. M., Shields, T. L.,et al. (eds.),Coronary-Prone Behavior, Springer-Verlag, New York, pp. 55–70.Google Scholar
  17. Rosenman, R. H., Friedman, M., Strauss, R., Wurm, M., Kositchek, R., Hahn, W., and Werthessen, N. T. (1964). A predictive study of coronary heart disease: The Western Collaborative Group Study.JAMA 189: 15–22.PubMedGoogle Scholar
  18. Shekelle, R. B., Schoenberger, J. A., and Stamler, J. (1976). Correlates of the JAS Type A behavior pattern score.J. Chron. Dis. 29: 381–394.PubMedGoogle Scholar
  19. Shekelle, R. B., Hulley, S. B., Neaton, J. D., Billings, J., Borhani, N., Gerace, T., Jacobs, D. J., Lasser, N., Mittelmark, 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.PubMedGoogle Scholar
  20. Schneiderman, N. (1987). Psychophysiologic factors in atherogenesis and coronary artery disease.Circulation 76 (Suppl. I): 141–147.Google Scholar
  21. Sprafka, J. M., Folsom, A. R., Burke, G. L., and Edlavitch, S. A. (1988). Prevalence of coronary heart disease risk factors in an urban black population: The Minnesota Heart Study, 1985.Prev. Med. 17: 321–334.PubMedGoogle Scholar
  22. Waldron, I., Zyzanski, S. J., Shekelle, R. B., Jenkins, C. D.,et al. (1978). Type A behavior pattern in employed men and women.J. Hum. Stress 3: 2–18.Google Scholar
  23. Winer, B. J. (1971).Statistical Principles in Experimental Design (2nd ed.), McGraw-Hill, New York.Google Scholar
  24. Zyzanski, S. J. (1978). Coronary prone behavior patterns and coronary heart disease. Epidemiologic evidence. In Dembroski, T. M., Weiss, S. M., Shields, J. L.,et al. (eds.),Coronary Prone Behavior, Springer-Verlag, New York, pp. 25–40.Google Scholar
  25. Zyzanski, S. J., Jenkins, C. D., Ryan, T. J.,et al. (1976). Psychological correlates of coronary angiographic findings.Arch. Intern. Med. 136: 1234–1237.PubMedGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1990

Authors and Affiliations

  • J. Michael Sprafka
    • 1
  • Aaron R. Folsom
    • 1
  • Gregory L. Burke
    • 1
  • Lorraine P. Hahn
    • 1
  • Phyllis Pirie
    • 1
  1. 1.Division of Epidemiology, School of Public HealthUniversity of MinnesotaS.E., Minneapolis

Personalised recommendations