Information about the relationship between Type A (coronary prone) behavior, the communication style of Type A individuals, and the cardiovascular (blood pressure and heart rate) response to communication is of vital importance in understanding the health effects of Type A behavior. The increased cardiovascular responsivity of Type A individuals contributes to their risk of developing coronary heart disease (CHD). Both Type A and B CHD patients are more reactive than comparable normals to psychomotor tasks. We will evaluate the independent physiological effect of a specific component of the Type A behavior pattern, rapid speech, and explore a behavioral strategy for controlling blood pressure and heart rate responses to communication. Two hundred CHD patients will have their blood pressures monitored with an automated oscillometric device at one minute intervals during a series of activities including resting quietly and reading at three different speeds: normal, maximal, and minimal. Order of the speeds will be randomly determined. The independent effects of rate of speech, number of words spoken, and coronary prone behavior (measured with the Jenkins Activity Survey and the Structured Interview) will be assessed using analyses of covariance with repeated measures and simple effects tests. The effectiveness of reducing the rate of speech at attenuating the blood pressure response to verbalization is of prime importance. This research will provide both an elucidation of the interrelationship of Type A behavior, rate of speech, and blood pressure reacting and a basis for the development and/or evaluation of therapeutic regimens aimed at modifying the cardiovascular responses to communication.
