The association between type a behavior and markers of vascular stiffness

The association between type-A behavior patterns (TABP) and cardiovascular morbidity and mortality is controversial. Accumulating evidence suggests that specific behavioral traits within the spectrum of TABP are associated with increased risk for cardiovascular complications. Yet, it remains unknown whether subclinical atherosclerosis as well as arteriosclerosis occurs more frequently in TABP. The aim of our study was to evaluate whether pulse wave velocity (PWV), a marker of arterial stiffness and vascular aging, is increased in volunteers with TABP and no known cardiovascular disease or overt risk-factors. One hundred and two healthy volunteers were included, of whom 29 (28.4%) reported as having features of TABP. Brachial-ankle PWV (baPWV) was computed according to accepted standards. In order to quantify the influence of multiple demographic and clinical variables on baPWV values, Pearson correlation analysis, and multiple regression analysis were conducted. Mean age was 32.2 ± 10.8 years for the non-TABP and 33.7 ± 10.4 years for the TABP group ( p = 0.514). Baseline characteristics and clinical parameters were comparable across the groups, with the exception of sex distribution (48% males in the non-TABP, and 69% in the TABP group; p = 0.044). Volunteers with TABP had significantly higher average baPWV (11.35 ± 2.30 m/s vs. 10.17 ± 1.63 m/s, p = 0.004). Differences were persistent following correction for multiple comparisons. The study was underpowered to detect differences in the baPWV between females with and without TABP. However, the difference in baPWV between TABP and the non-TABP groups was significant in males (12.18 ± 2.28 m/s vs. 10.72 ± 1.49 m/s, p = 0.008). In a multiple regression analysis following adjustment for other variables, TABP was significantly associated with baPWD (B = 0.71, SE = 0.30, β = 0.17, t = 2.34, p = 0.021, 95%CI 0.11–1.30). Specifically, individuals classified as exhibiting the TABP behavior pattern had baPWD values that were, on average, 0.71 m/s higher than those classified as non-TABP, holding age, sex, mean arterial blood pressure, and heart rate constant. In this preliminary cross-sectional and descriptive study, it was found that subjects with TABP had an increase in baPWV, suggesting a possible association between TABP and increased arterial stiffness. Research should be conducted to confirm the present findings in different and broader populations, as well as to determine whether there are any associations between baPWV and specific TABP traits, cardiovascular outcomes, sex, and study the possible benefits of early intervention. Thus, it is imperative to determine whether or not the association found in this study represents a causal relationship between TABP and increased arterial stiffness, as well as to identify the mechanism by which these two variables may be interrelated.