Type A Behavior in Healthy Males and Females as Related to Physiological Reactivity and Blood Lipids ULF LUNDBERG, PHD, MONICA HEDMAN, BA, BO MELIN, MSC, AND MARIANNE FRANKENHAEUSER, PHD Type A behavior was assessed in 30 men and 30 women (ages 30-50) by a Videotaped Structured Interview (VSI). Scores for total Type A behavior as well as subcomponents (competitiveness, time urgency, hostility) were examined in relation to cardiovascular and neuroendocrine reactivity during a work day (change from a work-free day) and during laboratory-induced stress (change from resting condition). In addition, Type A and Type B males and females were compared with regard to total serum cholesterol, LDL and HDL cholesterol, and triglycerides. The results showed relationships between 1) competitiveness/hostility and physiological re- activity at work in men, 2) total Type A behavior (and hostility) and serum cholesterol in men, and 3) hostility and serum cholesterol in women. As expected, the association between Type A behavior and physiological measurements was more pronounced for "extreme" Type A and B men and women (upper and lower 10 subjects, respectively) than for the total groups of each sex. INTRODUCTION The Type A behavior pattern (see ref. 1), which is characterized by an extreme sense of time urgency, competitiveness, impatience, and aggressiveness, has been proposed as an independent risk factor for coronary heart disease (CHD) (2). Some longitudinal studies (3, 4) have shown a twofold increase in the incidence of CHD in Type A individuals compared to their Type B counterparts. However, inconsist- ent and contradictory findings have been reported from several studies (5-7). From the Psychology Division, Department of Psychiatry and Psychology, Karolinska Institutet, Stockholm (U.L., B.M., M.F.) and Department of Psy- chology, Unit of Clinical Psychophysiology, Univer- sity of Gothenburg, Gothenburg, Sweden (M.H.). Address reprint requests to- Ulf Lundberg, Ph.D., Department of Psychology, University of Stockholm, S-106, 91 Stockholm, Sweden. Received April 20, 1988; revision received De- cember 16, 1988. The traditional risk factors for CHD, such as hypertension and cigarette smok- ing, as well as Type A behavior, have been found to be associated with elevated car- diovascular reactivity (8-10) defined as the change in physiological arousal from rest (baseline) to stress. Since elevated cardiovascular reactivity is assumed to contribute to the atherosclerotic process (e.g., ref. 11), this may be an important aspect of several CHD risk factors (12). Elevated catecholamine and cortisol lev- els are likewise considered potential risk factors for coronary artery disease (CAD), and some studies report larger catechol- amine responses in Type A than in Type B individuals exposed to challenging con- ditions (e.g., ref. 13). However, as pointed out by Frankenhaeuser et al. (14), this difference in reactivity between As and Bs is not seen under conditions that per- mit a high degree of personal control. Serum cholesterol, in particular as low density lipoprotein (LDL), is a potent risk factor for CHD (15,16), and several studies indicate an association between Type A behavior and serum cholesterol levels Psychosomatic Medicine 51:113-122 (1989) 113 0033-3174/89/5102-0113SO2.OO/O Copyright © 1989 by the American Psychosi latic Society