Hurrying a Heart Attack

Do you explosively accentuate key words in your sentences when there is no real need to do so, or deliver the last few words of a sentence much faster than the first? Do you try to hurry someone else's speech by interjecting "Yes, yes!" or by finishing his sentences for him? Do you try to do more than one thing at a time--work out a problem while someone is talking to you, or dictate to a secretary while driving a car? Do you often clench your fist or pound the desk for emphasis? Do you feel guilty if you are idle for a few days or even hours?

Anyone who answers most of the above in the affirmative has what Drs. Meyer Friedman and Ray Rosenman of San Francisco call Type A behavior. If he has not already had a heart attack, then he may be hurrying toward one. That, at least, is the conclusion of their book, Type A Behavior and Your Heart (Knopf; $7.95). Just published, the book not only helps people to determine if their behavior is hastening a heart attack but also offers some practical advice for those who want to avoid coronary complications.

Chain Reaction. Friedman and Rosenman are fully aware of the plethora of factors that contribute to the 20th century epidemic of heart disease and premature death: obesity and diabetes, high-fat and high-cholesterol diets, smoking and lack of exercise, and hereditary tendencies. But the two doctors maintain that behavior patterns are at least as important as any of the other causes and may indeed underlie some of them. For example, the Type A's instantly aggressive response to trivial slights and threats may set off a chain reaction of hormonal changes that can impair the metabolism of fats or cholesterol, thus accelerating the buildup of these substances in the coronary arteries.

The two physicians base their conclusions on a ten-year study of patients who were asked, among other things, to work a mazelike game to determine their frustration levels. They found more Type A's among professional men--attorneys, editors, advertising men, dentists and physicians. But, they insist, it is not merely what a man does that distinguishes the hard-driving Type A from the more easygoing Type B. A factory worker can be just as strongly Type A if he is concerned only about how fast he gets his job done, and sets his goals in terms of time and numbers rather than quality.

Changing Patterns. Changing a behavior pattern from Type A to B is difficult, but Friedman and Rosenman believe that it is possible. First, Type A must recognize himself for what he is. Then he must consciously try to slow himself down. The authors advise the Type A to get up earlier in the morning to allow time for a relaxed breakfast and avoid rushing for the 8:14. He should also schedule fewer appointments, stroll in a park after lunch and take time to be alone once in a while. He might, as a macabre reminder of his mortality, even write his own obituary from time to time.

It will take Friedman and Rosenman many years to determine whether their advice will actually prevent premature death from heart disease. In the meantime, they can study each other. Rosenman has never had a heart attack and, being a relaxed Type B, is not likely to suffer one. Friedman worked on his personality theory with typical Type A drive until his heart attack at age 55. That and a later coronary-bypass operation seem to have persuaded him to slow down. Friends now describe him as a mercifully modified Type A.

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