Effectiveness of Type A Counseling in Postmyocardial Infarction Patients and Normal Subjects

Abstract

Although my colleagues and I, as well as other investigators, had accumulated considerable evidence suggesting that TAB was associated with the incidence of clinical coronary heart disease in the two decades following the recognition of TAB in coronary patients in 1959, a direct, unequivocal connection between this syndrome and the pathogenesis of clinical coronary heart disease remained to be demonstrated. It was with this goal in mind that we designed a program in which a large number of patients who had suffered one or more myocardial infarctions would be randomized into two groups. The first group would be advised by cardiologists concerning well-recognized, possible preventive measures, such as cessation of smoking, ingestion of low-fat, low-cholesterol diets, adequate exercise, and other heart-related factors. The second group would be advised similarly by the same cardiologists but in addition would be given type A counseling by psychologists, psychiatrists, and several internists who had received training in type A group counseling.