Type A Behaviour and Risk of Coronary Heart Disease: The JPHC Study

Int J Epidemiol. 2008 Dec;37(6):1395-405. doi: 10.1093/ije/dyn124. Epub 2008 Jul 1.


Background: Although numerous studies of type A behaviour and risk of coronary heart disease (CHD) have been reported in the west (with mixed findings), few studies have been carried out in Asian populations.

Methods: We examined prospectively the association between type A-behaviour and risk of CHD incidence within a cohort of 86 361 Japanese men and women aged 40-69 years. A total of 669 cases of newly diagnosed CHD occurred between the baseline questionnaire (1990-94) and the end of follow-up in January 2004.

Results: We found no overall evidence of an association between type A and CHD incidence. The multivariate hazard ratio (HR) and 95% confidence intervals for CHD incidence in the highest vs lowest level of type A was 1.19 (0.94-1.51) overall. Contrary to expectation, Japanese men with lower levels of type A behaviour (lower levels of impatience, aggressiveness and competitiveness) appeared to be at significantly increased risk of CHD incidence (HR = 1.32; 95% CI 1.02-1.72). In contrast to men, there was insignificant but a tendency for reduced risk of CHD incidence (HR = 0.79, 95% CI 0.46-1.34) for women with lower levels of type A behaviour.

Conclusions: Type A behaviour does not predict CHD incidence in the Japanese population. Among males, type B behavioural patterns appear to confer increased CHD risk. Our findings suggest that the cardio-toxic effect of type A behaviour is gender-specific and culturally contingent.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Coronary Disease / etiology*
  • Coronary Disease / psychology
  • Female
  • Humans
  • Incidence
  • Japan
  • Male
  • Middle Aged
  • Risk
  • Risk Assessment
  • Type A Personality*