International Journal of Epidemiology 2001;30:363-369
© International Epidemiological Association 2001
Cardiovascular Disease |
Time urgency and risk of non-fatal myocardial infarction
a Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
b Department of Health and Social Behavior, Harvard School of Public Health, Boston, MA, USA.
c Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, MA, USA.
d Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
e Visiting Professor of Medicine, and Epidemiology and Public Health, University of Miami School of Medicine, USA. Current address: 1415 West Camino Real, Boca Raton, FL 33486.
Reprint requests: Dr SR Cole, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Avenue East, Boston, MA 02215, USA. E-mail: scole{at}rics.bwh.harvard.edu
Abstract
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 <0.001), 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 dose-response 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.
Keywords Coronary heart disease, non-fatal myocardial infarction, time urgency, impatience, Type A behaviour pattern, case-control study
Accepted 24 May 2000
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