Type A people are described as competitive, goal-oriented, productive, ambitious, leaders in the making who are in a hurry. They are competent and determined to be successful—and frequently are. The problem is that they are also likely to be hostile and angry.
The specific aspects of a Type A individual that continue to be related to heart disease are explosive reactions, competitiveness, impatience, irritability and hostility. Lumped together these traits equal anger.
It is the tendency to be angry and hostile that results in the Type A paradox: the anger that drove you to triumph over all obstacles to reach professional heights is the same behavior that puts you at risk for serious illness and death. Closer examination suggests that the crux of the matter is motivation. Type As seek excellence to prove their worth. Type B people, on the other hand, can also achieve personal success but do so because the process is enjoyable to them. Type Bs feel secure inside and do not need hostility or competition to succeed.
While discussions about adrenaline and noradrenaline—two of the stress hormones associated with the sympathetic nervous system (SNS); its opposite, the parasympathetic nervous system (PNS) is less frequently discussed. This is unfortunate since the parasympathetic nervous system is vital for survival. When activated the parasympathetic nervous system released a compound called acetylcholine to any tissues served. Once inside of a cell acetylcholine has the ability to neutralize adrenaline. Most organs involved in the fight or flight response receive input from both the sympathetic and parasympathetic nervous systems. The PNS can put the brakes on the fight or flight physiological changes. It cools us down and calms us. It puts the brakes on anger.
In a series of studies carried out in Japan it was discovered that Type A men, especially those with high hostility levels, have weaker parasympathetic nervous systems than men with low hostility levels. An effective PNS can help counter the effects of the SNS which results in the heart working less hard and lowering the risk for developing heart disease.
There is also research that indicates that the immune system may be weaker in hostile people. The immune system is thought to play an important role in helping keep us cancer free, especially in the action of “natural killer cells” which can kill tumor cells that form in the body. A study involving low and high hostility scoring med students indicated a reduction in the natural killer cells in the blood of high hostility students during high-stress exam periods.
In summary, hostile Type A people are wired differently. Their SNS is activated at the slightest provocation while nonhostile people’s SNS show relatively small responses to even strong stimuli. The end result is that hostile people spend more time under the influence of an aroused nervous system which can set the stage for the development of heart disease because of repeated exposure to elevated cardiac demands, increased mobilization of cholesterol into the blood, and increased clumping of platelets while the immune system functions are decreased. This difference in exposure may account for the increased death rates seen in aggressive Type A individuals.
If your immediate impulse when faced with having to wait in traffic or in a long line at the grocery checkout, or dealing with a recalcitrant computer is to start blaming people, and getting angry you are slowly killing yourself. Your anger has turned into hostility and you are at increased risk from death from many causes.
Research indicates that high hostility levels in older men are strongly related to the development of heart disease. Hostility appears to be a greater risk factor than high cholesterol levels, smoking, and being overweight. Furthermore the older men in this study with the highest levels of hostility were at the greatest risk of developing heart disease. This increase in risk appeared to be independent of insulin levels, body mass index, waist-to-hip ratio, triglyceride levels and blood pressure. In other words, being highly hostile appeared to be more closely related to the development of heart disease than the more commonly thought of risk factors and the higher the hostility level the greater the likelihood of developing heart disease.
Constant chronic feelings of anger, hostility and aggression raise the risk of developing arteriosclerosis and coronary heart disease as much as five times the normal rate. Suppressing anger is not a major contributor to heart disease; over-experiencing and over-expressing anger is the villain.
Research has indicated that anger causes high blood pressure in hostile people in much the way salt increases blood pressure in people who already have high blood pressure.
Anger is a poison for hostile people. In a research study that examined the effect of harassment on men trying to perform a mental test, ONLY highly hostile men showed increases in blood pressure and blood flow to the muscles. Men who scored low on the hostility scale did not demonstrate these physiological changes. The high hostility group also reported much higher levels of anger and irritation afterward than the less hostile men. In a second study the high hostility men were shown to also have a larger increase in stress hormones than the less hostile men. This closer connection between anger and physiological hyperactivity can be one of the explanations why hostile people have more health problems. Hostile people need to control their anger if they want to avoid increasing their risk for health problems.
Social costs of anger
It is no fun being around someone who is constantly angry. Hostile, angry people are not happy. Not only do hostilely angry people hurt their spouses but they also hurt their children. While they may not resort to physical violence, verbal abuse is common and extremely detrimental to the children. If nothing else anger can reduce the intimacy in personal relationships as your partner and other family members become more guarded in their interactions with you.
Hostile individuals also report more stress in the interpersonal aspects of work. They are less satisfied with their jobs and have a negative view of work relationships. In addition, an aggressive interpersonal style sabotages the goodwill of subordinates and lowers the probability of work goals being met. Colleagues begin to avoid the hostile employee resulting in the chronically angry individual feeling isolated.
Many hostile people blame everyone else for their social problems. This is unfortunate because lack of a social support system is one of the paths a hostile person can take to serious disease. Angry people frequently have cynical attitudes toward others and are unable to recognize or utilize support when it is available; especially if the offers for help are judged inferior because of their overly demanding expectations. When genuine attempts to help are shunned or ridiculed it only worsens the situation, pushing others further and further away.
Finally, angry people tend to drink, smoke and eat more than their less angry counterparts. Without a social network of people to dampen these tendencies the probability of serious health consequences seems inevitable.