Coronary Heart Disease

Despite considerable advances in research and practice over the past three decades, cardiovascular disease and, in particular, coronary heart disease (CHD) remains the primary cause of premature death in the United States. This chapter will illustrate the various methods and concepts within health psychology that have been applied to further our understanding of the factors that contribute to CHD and the various prevention and intervention strategies used to reduce the risk of CHD morbidity and mortality. This chapter will first provide an overview of etiological considerations, including a definition of CHD and specification of risk factors. The remainder of the chapter will focus on “coronary-prone behavior pattern,” or the Type A behavior pattern, as it relates to the development and maintenance of CHD. As was discussed in Chapter 1, this behavior pattern represents the first well-defined psychological or behavioral risk factor in the history of risk factor research in health and illness. Therefore, the Type A behavior pattern will be emphasized, with a focus on (1) defining the pattern and presenting it in historical perspective, (2) describing the pattern and the methods used to measure and identify it, (3) reviewing the research validating the Type A construct and providing an overview of the psychological aspects of the behavior pattern, and (4) reviewing the psychophysiological