CORONARY RISK FACTORS: STRESS

The wild card in the coronary risk pack is stress. The heart and circulatory system respond to stress. The pulse rate quickens. Blood pressure rises. Emotion can affect heart rhythm, causing extra beats, which give the impression that your heart has missed a beat. Blood pressure can be lowered quite dramatically by various relaxation techniques. Whether the effects of stress are long-lasting and produce physiological changes which predispose the individual to coronary heart disease remains unclear. Stress may in fact be the straw that breaks the camel\'s back.

The most compelling evidence for a link between personality type and coronary heart disease is research on the so-called Type A personality or behaviour pattern. Type A people are strivers, ambitious and competitive. They are impatient and always pressed for time. Several studies have shown that they have a much higher incidence of heart attacks than do people who do not have these Type A characteristics.

Friedman and Rosenman, in their book Type A Behaviour and your Heart, have shown that it is possible to do something about the coronary-prone Type A personality. They suggest simple behaviour modification techniques which they believe may be helpful in teaching coronary-prone individuals to change certain aspects of their behaviour. For example, they can schedule fewer people to meet and less work to do in a given time period, or shorten the time allotted for various activities, so that they have frequent \'free periods\'. The business lunch can be replaced by a walk in the park.

However, Friedman and Rosenman admit that changing coronary-prone behaviour may not be an easy task. Coronary prone individuals will often resist serious attempts to change their behaviour patterns. They may want to avoid a coronary attack but they do not necessarily want to change their behaviour. The desire for higher status or more money may more than offset the fear of a heart attack. The coronary-prone Type A personality appears to be the product of modern society. If so, society must change too, as well as the individual.

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