The Relationship Between Type A Personality and Heart Diseases: Overview

The Relationship Between Type A Personality and Heart Diseases: Overview
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Overview on Personality Types

Personality type refers to the psychological classification of individuals. The major classification is Type A and Type B, based on behavioral patters.

Type A behavioral traits include impatience, time-consciousness, competitiveness, ambition, aggressiveness, controlling and the like. People with Type A personality are business-like and workaholics, always involved in an incessant struggle to achieve more and more in less time, and have difficulty relaxing.

Type B behavioral traits are the opposite of Type A. Type B individuals are patient, relaxed, easy-going, and lack an overriding sense of urgency.

Very often, people with Type A personality find fault with the easy-going nature and low level of enthusiasm demonstrated by Type B personalities, and Type B personalities would dislike people with Type A personalities for their aggressive nature.

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Friedman & Rosenman’s Research

Cardiologists Meyer Friedman and R. H. Rosenman first described the relationship between personality types and heart diseases. They concluded Type A behavior as a potential risk factor in coronary disease, based on a nine-year study of healthy men aged 35–59, conducted in the 1950s. They estimated that Type A behavior doubles the risk of coronary heart disease in otherwise healthy individuals.

The reasons for their conclusion were:

  • the fast-paced nature of Type A individuals and their stress on deadlines, work and the like making them highly susceptible to stress
  • the competitive nature of Type A personalities making them angry, tense and pressurized
  • type A behaviors such as fast talking, explosive speech, clenched fists, restlessness, and hurrying being general indicators of an underlying unhealthy emotional state

Such traits led to high blood pressure, high cholesterol, and habits such as smoking, all proven causative factors for cardiac diseases.

Friedman & Rosenman published their theory in their 1974 book “Type A Behavior and Your Heart,” which made the theory of associating type A personality and heart disease popular.

Shortcomings of Friedman & Rosenman’s Theory

While Friedman & Rosenman’s theory linking Type A personality with heart diseases persist as a pop psychology within the general populace, it has received widespread criticism for its scientific shortcomings.

The major criticisms levied include:

  1. the overly simplistic nature of research, with no scope to assess the degrees of difference in human personality.
  2. the serious limitations of the study, such as large and unequal sample sizes, and less than 1% of the variance in relationship explained by Type A personality
  3. unreliability of the methods used to assess Type A behavior. The SI method entailed the interviewer challenging the subject and recording the verbal responses, and nonverbal emotional reactions. The JAS method was a paper-arid-pencil self-report questionnaire with three standard subscales.

On the next page, we’ll look at subsequent research that tries to address the shortcomings of Friedman’s & Roseman’ theory, and other research that debunks the association of Type A personality and heart diseases.

Further Research by Friedman, Hall & Harris

In 1985, H. S. Friedman, Hall, and Harris attempted to refine the Type A / B classification and address the major criticism that not all people with Type A personality have high blood pressure, and many Type B individuals have high blood pressure.

They identified that some individuals labeled Type A not encountering heart disease was because they were not Type A personality in the first place. An active, hard-working, ambitious and proactive leader may, for instance epitomize the idea of hurry sickness, when such a vigorous person need not necessarily share the emotional reactions of impatience, hostility, and tenseness usually characteristic of the coronary-prone person. Similarly, loud speech, rapid speech, and short response latencies could be cues of alertness and vigor rather than hurry sickness.

Individuals labeled Type B became prone to heart disease because they were not Type B individuals in the first place. Some people repress hostility and ambition and remain quiet, slow to speak, and non-aggressive on the surface, but are actually Type A personalities.

Hostility as a Predictor of Heart Diseases

Relationship Between Personality Types and Heart Diseases

Other researchers’ find Type A personality unreliable to predict coronary heart disease.

Research by Redford Williams of Duke University indicates that only the hostility component, or a high level of expressed anger and hostility of Type A personality denotes a significant risk factor for heart disease. Irrespective of the personality type, cynical, resentful, chronically angry, and mistrustful men remain highly susceptible to coronary events such as hospitalizations for angina, nonfatal myocardial infarction, stroke and congestive heart failure.

The University of Pittsburgh School of Medicine researchers reinforce the theory of hostility as a causative factor for heart diseases by using carotid-artery imaging. Each one-point increase in hostility scores predicted a significantly higher intimal-medial thickening.

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Other Research

Another 10-year joint research by Italian and Sardinian researchers, the U.S. National Institute on Aging, and bio-statisticians of the University of Michigan, while indicating a clear influence of genetic factors on many traits at once, did not find a connection linking personality and cardiovascular function.

The relationship between personality types and heart diseases is therefore at best indicative, and not conclusive.


  1. Bates, Karl Leif. Study: Type A personality not linked to heart disease. University of Michigan
  2. Friedman, Howard, S.; & Booth-Kewley, Stephaine. Personality, Type A Behavior, and Coronary Heart Disease: The Role of Emotional Expression. University of California, Riverside
  3. Geipert, Nadja. Don’t be mad. More research links hostility to coronary risk. American Psychological Association