Hostility, fast-paced life may hurt heart


"Oh, he's a Type A," someone might say, using what has become a bit of pop-psychology shorthand for describing someone who works -- and plays -- relentlessly and feels a constant time urgency.

Since 1959, when Meyer Friedman and Ray Rosenman reported that men with those characteristics were seven times more likely than others to have heart disease and twice as likely to have heart attacks, most lay people have linked those competitive, hostile behaviors to coronary disease.

But as the scientific study games go, the ball has been thrown quietly and slowly into another court of opinion.

In 1990, Robert Levine, chair of the department of psychology at California State University, Fresno, published the results of a study that looked at rates of heart disease and the pace of life, in American Scientist magazine. Now he's doing a follow-up study. "We're trying to characterize, better than studies before, the predictors and consequences of pace of life," he says. And for good reason. Heart disease is the No. 1 cause of death in the United States.

While the first study showed him he could be on the right track, the second will try to determine the why of findings such as that Boston has a slightly faster pace of life than New York. Los Angeles had the slowest pace in the 36 U.S. cities studied. Of the six countries measured, Japan had the fastest pace of life followed by the United States, England, Taiwan and Italy. Far slower than the others was Indonesia.

What was important, he writes in the magazine report, is that "our data suggest that the pace of a person's environment is at least as good a predictor of heart disease as his or her score on a Type-A personality test." It was the exception that he found interesting: Japan has the fastest-paced life in the world. And at first glance, Japanese people in general might be described as having the typical Type-A personality. That would mean they should have a high rate of coronary disease. But they don't.

Dr. Levine noticed that while Japanese people do indeed work long, busy hours, they are not of the "hard-driving" mind-set. While he has yet to prove his hypothesis (this is part of what he's studying now), he says, "There is not a lot of overt, competitive hostility in the culture. People are working for the group. It could be that it's not the fast pace of life alone, but the hostility element that contributes to heart disease."

No matter that Japanese work hard and that life takes place at warp speed. They apparently are comfortable with those conditions. Dr. Levine adds what has become an important caveat to his first report: "Although we have come to view the choice between rushing and leisurely activity as a trade-off between accomplishment and peace of mind, we should note that time pressure is not always stressful; it may also be challenging and energizing. . . . What we have characterized as a Type-A environment will affect different people in different ways. What may be most important is fitting people to their environment."

In view of this, the study now under way takes account of 'D another factor. "We're looking again at rates of death by coronary disease, and we're looking at life satisfaction ratings. What's interesting is that those who have a faster pace of life may have higher rates of coronary disease, but some also have higher life satisfaction even if they are experiencing stress. It's a mixed blessing."


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