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Want hypertension? Hurry up!
November 20, 2002

CHICAGO, 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.

This pioneer 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.

"Our findings 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 long term."

Numerous studies 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 risks.

"The TUI 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 health outcomes."

Researchers at 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.

Participants were 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.

"On average, 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."

The probability 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 lowest group.

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.

"The association 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.

"It's important to realize that these are modifiable personality traits, and reducing TUI tendency may possibly decrease future health risks related to TUI," Liu says.

Other co-authors 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., Ph.D.

The CARDIA study was funded by the National, Heart, Lung and Blood Institute. 

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