My friend Raj has always been a classic Type A personality. He becomes restless anytime he has to wait; he hollers at other drivers in traffic; he often doesn't bother to sit down when he eats. He is also hypertensive, with a blood pressure of 150/90 at age 34. This past week I decided to share with him the results of a new study presented at this year's American Heart Association meeting. Although he always knew his lifestyle wasn't healthy, he thought it wouldn't affect him much--or at least that his relative youth would protect him for now. It turns out he may be wrong on both counts.
A Type A personality is thought to be made up of three parts: competitiveness, hostility and time urgency/impatience, or TUI. Research in the past has shown that competitiveness is not linked to health problems, whereas hostility is. Now a pioneering study has implicated TUI too.
Lead author LiJing Yan of Northwestern University enlisted more than 3,000 young adults--men and women, black and white--between 18 and 30 and tracked them for 15 years. She asked them to consider four traits: 1) a tendency to get upset when having to wait, 2) a tendency to eat too quickly, 3) a feeling of pressure as the end of the regular workday approaches and 4) a feeling of time pressure in general. The respondents were then asked to rate how well these traits described them, on a scale from "very well" to "not at all." By year 13, a clear trend had emerged. Those who gave positive responses in all areas were twice as likely as the others to have developed moderate to severe hypertension (blood pressure of 140/90 or higher).
For the first time, people like Raj had concrete evidence of what a hurry-up lifestyle can do to the body. To be sure, hypertension can be caused by a wide variety of other factors --genes, diet, smoking and a lack of exercise. But now another behavioral dimension can be added to the mix.
To treat his hypertension, Raj will be seeing his doctor and will probably be placed on antihypertensive medication. I assured him this was a good thing because uncontrolled hypertension could lead to heart disease, stroke, kidney failure and even dementia.
But I couldn't help wondering whether behavior modification could assist the drugs in bringing down his blood pressure. Raj, who fidgets when he has to wait 10 extra seconds for an elevator, would be unlikely to last through a behavior-modification session like biofeedback training.
But what about something else? Dr. Laurence Sperling, a cardiologist at Emory University in Atlanta, says in severe cases, antianxiety medications may become part of hypertension treatment. Raj scoffs at that prospect, but he realizes now that his temperament could have tremendous health consequences he didn't have time to consider. --With reporting by Debra Goldschmidt/New York
Dr. Gupta is a neurosurgeon and a cnn medical correspondent