Type a coronary-prone behavior pattern and cardiovascular risk factor variables in children and adolescents: The Bogalusa Heart Study

Abstract

The relationship between Total score from the Hunter-Wolf A-B Self-Rating Scale for children (and derived Factors) and several cardiovascular risk factor variables was observed in children ages 10–17 in a biracial community. After analysis, effects of age, weight and height were removed from the Total A-B score, each Factor score, and risk factor variable. Differences in risk factor variables were observed in relation to A-B, race and sex. For each sex-race group, the four Factor scores and Total score were ranked into quintiles. Children in the upper quintile were referred to as Type A children and those in the lower quintile, Type B. For Factor 1, which describes eagerness and energy in children (Eagergy), significant mean differences were found for serum total, β- and pre-β-lipoprotein cholesterol and triglycerides. In each instance, children classified as Type A exhibited approximately 10 mg/dl higher readings, except for pre-β-lipoprotein cholesterol in which a 2 mg/dl difference was noted. Two significant second order interactions were found for systolic and diastolic blood pressure. Black boys who scored in the A direction had higher systolic blood pressures, while Type A girls had higher diastolic blood pressures than their Type B counterparts ( p < 0.05). For Factor IV, which is related to feeling hurried, there was an approximate 10 mg/dl difference in serum total and β-lipoprotein cholesterol in the direction opposite to that predicted. Although the relationships between A-B coronary behavior pattern and risk factor variables in children are of low magnitude, the relationships are being observed in the direction that might be predicted. Measurement of Type A in children requires further refinement in concept identification and valid measurement.