The personality type that increases the risk of having a heart attack

“It takes a certain degree of hostility to make it in the world.” “Other people are ignorant and inept.” “They’re going to regret what they’ve done.” “Giving and receiving love is a sign of weakness.” “If I don’t take care of things, nobody will.” “I shouldn’t have to repeat myself.” This kind of thinking characterizes a personality profile called Type A.

In the 1950s, American cardiologists Meyer Friedman and Raymond Rosenman differentiated four personality types (A, B, C, and D) based on how people reacted to various situations. Each person has a combination of traits, even if a certain type predominates. Type B personalities are people who are relaxed, cheerful, patient, carefree, uncompetitive and conformist. Type C describes people who are systematic, thoughtful, sensitive and prudent. While the Type D personality is easily embarrassed, negative, pessimistic and socially inhibited. Both the behavior profile of Type A and Type D personalities are considered cardiovascular risk factors as they are more prone to stress, and this negatively impact health.

These personality types tend to think rigidly, and are almost never satisfied. They may have interpersonal conflicts due to their failing to nurture close relationships, and lack close friends. Psychologically, they are in a state of physical and mental hyperalertness and this makes them ignore their body’s needs and overlook the importance of rest. This state affects the nervous system, leading to a rise in heart rate, blood pressure, muscle tension, cholesterol levels and triglycerides.

A high percentage of people who have a heart attack identify as Type A personalities. Many patients try to change these personality traits in order to reduce their risk of cardiovascular disease. Having the right attitude is key because, as Seneca said, “The wish for healing has always been half of health.” These personalities need to be given techniques or standards of conduct so that they can learn to differentiate between what’s a priority and what’s not. It’s important for them to learn how to distinguish between what is and what is not under their control; set realistic goals and properly manage time; verbalize positive and negative emotions; practice meditation or relaxation techniques every day, and express gratitude.

But what is most difficult for patients with a Type A personality is managing anger and aggressiveness. According to Aristotle, “Anyone can become angry — that is easy, but to be angry with the right person, and to the right degree and at the right time, and for the right purpose, and in the right way — that is not within everyone’s power and that is not easy.” Aggression can be triggered by negative thoughts, like the ones expressed at the beginning of the article, or if a person is keeping something in until they explode. There are several books on anger management: from the classic On Anger by Seneca to the contemporary How To Control Your Anger Before It Controls You by psychologist Albert Ellis.

The goal is not to keep things pent up, but rather to express feelings as they come up, in an appropriate manner. To do this, we need to be aware of situations that cause anger to boil over. Sometimes it’s a good idea to tell the other person that you are starting to get agitated and that you are going to take a walk until you calm down. Other times, it is better to give an excuse (go to the bathroom for a moment or say that you have to leave), and use the “time out” period to do something that calms you down. This can be telling yourself positive affirmations such as “I’m going to be calm” or trying to distract yourself by counting from 100 to zero by sevens. Focusing your attention on an object in the room or on a shop window if you’re outside also works. It’s also important for us to reflect our irrational beliefs regarding challenges, success, ambition and how we see ourselves. These irrational beliefs strengthen the traits of the Type A personality.

That’s according to the book Corazón y mente (or, Heart and Mind) by Luis Rojas Marcos and Valentín Fuster, who highlight the importance of reviewing life’s priorities. If health and quality of life were valued more, it would be easier to manage anger.

Patricia Fernández Martín is a clinical psychologist at the Ramón y Cajal Hospital in Madrid.