November 20, 2002
IL (AHA) – Young adults who fume at
the slowpoke ahead of them on the freeway may be racing toward
high blood pressure, researchers reported at the American Heart
Association’s Scientific Sessions 2002.
study examined the relationship between the feeling of being
pressed for time and impatience with the development of
hypertension in young urban adults. Time urgency/impatience (TUI)
is a major component of so-called Type A behavior patterns.
Other characteristics of Type A are competitiveness, hostility,
tenseness and aggressiveness.
indicate that TUI assessed during young adulthood is associated
with increased risk of hypertension years later," says lead
author LiJing L. Yan, Ph.D., research assistant professor of
preventive medicine at Northwestern University in Chicago. "In
general, the stronger the feelings of impatience and time
pressure, the higher the risk of developing hypertension in the
have examined the intense traits that characterize Type A
personality and their potential effects on health. But results
have been inconsistent, leading some researchers to explore
whether different components of Type A have different health
component of Type A is characterized by a persistent
preoccupation with time and pronounced impatience," she says.
"To our knowledge, this is the first study to concentrate on the
relationship between TUI and hypertension, a very common health
condition and a strong risk factor for heart disease.
"In the past,
more attention has been paid to the hostility component in Type
A, but TUI has never been adequately examined as a separate
trait, despite suggestions that it may be linked to adverse
Northwestern University, the University of Pittsburgh and the
University of Alabama at Birmingham, used information from the
large-scale CARDIA (Coronary Artery Risk Development in Young
Adults) study to track 3,142 people for a 15-year period.
Participants included both men and women – black and white –
ranging in age from 18 to 30 when the study began.
asked to rate how well such traits as "eating too quickly,"
"getting quite upset when having to wait for anything," "usually
feeling pressed for time" and "often feeling time pressures at
the end of a work day" described them. Responses ranged from
"very well" to "not at all." Researchers measured their levels
of time urgency and impatience at year 0 and year 2 exams – the
start of the study. In year 15, researchers classified the
people taking anti-hypertension medication or with readings of
140/90 millimeters of mercury (mm Hg) or more as having high
blood pressure. Those with high blood pressure at year 0 or year
2 were excluded from the study sample. The remainder was
followed for 13 years (from year 2 to year 15).
Only 6 percent of
the participants gave positive responses in all areas, which
placed them at the highest level of TUI. Their 13-year incidence
of hypertension was 17 percent compared to 10 percent for people
with the lowest TUI scores. After adjusting for factors such as
age, race, gender, body mass index, physical activity level and
alcohol intake, researchers found that people with the highest
TUI scores were more than twice as likely to have developed high
blood pressure than those with the lowest score.
people with higher TUI scores were more likely to be white,
female and better educated," Yan notes. "However, they also
tended to have a less healthy lifestyle. They smoked more, drank
more alcohol and had less physical activity."
of developing hypertension by year 15 was almost twice as high
for black men (22 percent) and women (21 percent) compared to
white men (12 percent). The exception however, was for white
women – who had the lowest overall probability (5 percent).
Black men and
women in the highest TUI groups were about twice as likely to
develop high blood pressure as black men and women in the lowest
TUI groups. White men in the highest group were more than three
times as likely to become hypertensive as white men in the
TUI is related to
a poor health-risk profile that includes smoking, drinking, high
hostility levels and a lack of social support – most of which
are related to hypertension, Yan says. It's also conceivable
that stressful work or home environment, anxiety, hostility,
excessive alcohol consumption and other factors may aggravate
the sense of TUI.
between TUI and development of hypertension may be mediated by a
variety of lifestyle and other psychosocial factors," says Kiang
Liu, Ph.D., senior author and professor of preventive medicine
at Northwestern University. "The complex processes involved in
the link between chronic exposure to TUI and hypertension are
not yet well understood."
He notes that
more studies are needed to confirm these findings and to
identify potential biological mechanisms.
to realize that these are modifiable personality traits, and
reducing TUI tendency may possibly decrease future health risks
related to TUI," Liu says.
are Karen A. Matthews, Ph.D.; Martha L. Daviglus, M.D., Ph.D.;
T. Freeman Ferguson, M.P.H, M.S.P.H.; and Catarina Kiefe, M.D.,
The CARDIA study
was funded by the National, Heart, Lung and Blood Institute.