SHOULD WE INTERVENE TO MODIFY TYPE-A BEHAVIORS IN PATIENTS WITH MANIFEST HEART-DISEASE

Until the mid 1980s Type A Behaviour (TAB) was considered to confer th e same magnitude of risk for CHD as smoking, hypertension and raised s erum cholesterol. As such, it was considered a suitable target for mod ification, particularly in post-infarction populations. More recently, three arguments have been suggested that counter such optimism: (i) r ecent evidence may suggest TAB is not predictive of heart disease in p ost-infarction populations; (ii) interventions do not influence physio logical processes underpinning TAB and, accordingly, do not reduce ris k for disease progression; (iii) there are other, more useful, interve ntions that may be conducted with cardiac patients. The validity of ea ch of these challenges is critically examined. It is concluded that in terventions to modify TAB in patients with manifest heart disease are still of value in reducing risk for further disease progression.