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Posted: December 10, 2010 12:30 a.m.

Personality and Health

Your attitude can effect how healthy your heart is.

According to a study recently released in "Circulation: Cardiovascular Quality and Outcomes," individuals with a "distressed" personality, known as a Type D, when compared to optimistic individuals, are three times more likely to develop heart problems such as heart failure, peripheral artery disease and death.

The Type D personality was first defined in the ’90s and is characterized by feelings of negativity, stress, anger, anxiety, depression and loneliness. Type D personalities are generally pessimistic and tense, often chronically angry and overreact to stress. They also tend to keep their feelings to themselves out of fear of rejection. According to the study author, Johan Denollet, a psychologist at Tilburg University in the Netherlands, about 20 percent of healthy Americans are Type D’s, and half of people being treated for cardiac problems are Type D.

Denollet’s study consisted of the analysis of 49 prior studies that involved more than 6000 people. Their conclusions were that Type D personality types are more likely to die, especially for heart patients, than other personality types. "It really adds weight to the argument that this core, hostile personality is a concern — or ought to be a concern — for people who have it," stated Barry Jacobs, a clinical psychologist and spokesman for the American Heart Association. "If you perceive things in a particularly skewed, negative way, your body will become more reactive over time, and there will be long-term health consequences."

In a prior study by Denollet, 300 heart patients in a cardiac rehabilitation program were examined. He found that 27 percent of those classified as Type D died within eight years, mostly of heart attacks or strokes. Non-Type D patients had a seven percent mortality rate in the same period of time.

So what is it that is killing Type D personality types? The answer is our old nemesis to most health problems, stress. Type D’s run pretty high levels of stress, compared to non Type D’s who vent their feelings and speak up for themselves. With no outlet for stress, the effect on the body is increased levels of cortisol which tend to elevate blood pressure and inflamed arteries that become damaged. Denollet also states that behavior is important. Type D’s are less likely to quit smoking, less likely to exercise and tend to be non-compliant with treatment programs. Characteristically tense and insecure in social settings, Type D’s are also more likely to avoid medical care and avoid discussing worrying symptoms with their doctors.

Are you a Type D? Without a formal evaluation, you can do an informal assessment. Do you often feel unhappy? Are you irritable a lot and in a bad mood? Do you have a fairly dark world view? Do you make a big deal out of little things? Is it difficult for you to start a conversation? Do you keep people at a distance? If you find yourself answering "yes" to some of these questions, you may be at risk of heart disease.

Personality is difficult to change, but it can be done. Psychotherapy can help those who are unhappy and pessimistic, but psychotherapy and cognitive behavioral therapy aren’t the only ways to change. As Barry Jacobs states, "People can work on changing their outlook. Sometimes they turn over a new leaf because of an experience they’ve had, and they learn to count their blessings. Having a good attitude about the world, avoiding negative thinking, and learning to relax all become part of a heart-wellness program."

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