Time urgency and risk of non-fatal myocardial infarction
S. R Cole
2001
International Journal of Epidemiology
Data concerning Type A behaviour pattern (TAB) and coronary heart disease (CHD) are inconsistent. Type A behaviour pattern is an amalgamation of several elements, including aggressiveness, hostility, ambitiousness, competitive drive, and a chronic sense of time urgency. 1 Some of these, referred to as 'toxic' elements, may be associated with risk of CHD, while others may not. 2 Thus, simple summary scores for TAB of linear combinations of these various behavioural patterns would predict CHD
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... in samples where the toxic element(s) are weighted strongly in the summary score. Such a situation could arise using a TAB scale that incorporates a large number of items from the toxic relative to the non-toxic elements. This is a measurement problem where the instrument is recording several constructs instead of a single construct, i.e. lack of unidimensionality. 3,4 Much of the literature on TAB has focused on hostility as the toxic component of the behaviour pattern. 5 However, an inadequate number of studies have examined the cardiovascular risk associated with other components of the behaviour pattern, 6,7 such as time urgency, which is characterized as a persistent preoccupation with time and need to complete tasks in a hurry. Indeed, the gold standard for measurement of TAB is the videotaped clinical examination (VCE), 8 which devotes approximately equal emphasis to the measurement of time urgency and freefloating hostility. Background Inconsistencies in the literature linking Type A behaviour pattern (TAB) to coronary heart disease (CHD) may be due to differences in the effects of various components of TAB, namely aggressiveness, hostility, ambitiousness, competitive drive, and a chronic sense of time urgency. Methods We investigated the association between sense of time urgency/impatience and non-fatal myocardial infarction (MI) in a study of 340 cases and an equal number of age-, sex-, and community-matched controls. Results A dose-response relation was apparent among subjects who rated themselves higher on the four-item time urgency/impatience scale (P-value for trend Ͻ0.001), with a matched odds ratio (OR) for non-fatal MI of 4.45 (95% CI : 2.20-8.99) comparing those with the highest rating to those with the lowest. After further adjustment for family history of premature MI, physical activity, body mass index, occupation, cigarette smoking, total caloric intake, per cent calories from saturated fat, alcohol intake, lipid levels, treated hypertension and diabetes, the dose-response relation remained (P-value for trend = 0.015) and the adjusted OR for MI was 3.99 (95% CI : 1.32-12.0) comparing those with the highest rating to those with the lowest. Conclusion In these data, a sense of time urgency/impatience was associated with a doseresponse increase in risk of non-fatal MI, independent of other risk factors. Prospective cohort studies of time urgency/impatience and incident CHD events are needed to confirm or refute these observations from a case-control study.
doi:10.1093/ije/30.2.363
pmid:11369743
fatcat:n3524ixzsffnth2crcauuy5m5e