A Surprising Risk Factor of Coronary Heart Disease. And no, it's not smoking or high blood pressure



BY DR. YUHONG DONG AND BETH GIUFFRE

I am afraid that I am rather amused by the article by or about Dr Dong that I have reproduced in part below. It is a very long and rather repetetitious article so I have reproduced only the beginning of it. But I think the excerpt is sufficient to give a good idea of the whole

Put simply, Dr Dong clearly has only a glancing familiarity with the research literature on his suibject. His mention of the A-B personality concept as a predictor of coronary heart disease is particularly regrettable. Its customary measure was a scale called the JAS, which was really woeful from a psychometric point of view. It was a confused jumble of many ideas and already by the 1980s had been repeatedly shown NOT to predict CHD. Any mention of the claims concerning it at this juncture is quite simply embarrassing from a scholarly viewpoint.

I summarize here some of the research literature pointing to the irrelevance of A-B -- including in passing some of my own research on the subject


How many times have we heard the “smoking, drinking, and being overweight” warning in relation to heart disease? Yet, one of the longest-running studies contradicts this.
A much bigger risk factor is stress—particularly the kind of stress found in a specific personality type that processes anger in a particular way.

The Framingham project is the quintessential epidemiological population study, of more than 14,000 people across three generations. And a key piece of lifestyle advice is hidden in the 1980 analysis of the final cohort.

Do you feel guilty if you use free time to relax? Ask yourself these “Type A” identifier questions, and check whether you also process stress in these same ways—this stress management protocol is a key driver of coronary heart disease.

Physically, anger leads to catecholamine release, which has a host of cardiovascular repercussions. In “fight mode,” the liver synthesizes triglycerides in a boost of energy, which in turn contributes to lipid disorders.

If this is you, there’s still no need to be fatalistic. These are behavior patterns that we can train and change, and changes start small. Rome wasn’t built in a day.

According to the National Center for Health Statistics, heart disease is the leading cause of death in the United States. One in five Americans died from heart disease in 2020, as reported by the Centers for Disease Control and Prevention (CDC). Worldwide, cardiovascular disease is also the leading cause of death year after year.

Coronary heart disease (CHD) is the most common type of heart disease, killing nearly 383,000 Americans in 2020. Scientists and the medical community are investing much time and money into the study of what keeps the heart healthy and what can stop it from beating.

Many risk factors have been suggested for CHD. Among these, high blood pressure, high blood cholesterol, and smoking have been assumed to be leading causes. Doctors wear themselves out by repeating the same warnings that CHD could be much reduced if people would reduce their bad cholesterol levels by eating healthy food and becoming active. People need to quit dangerous habits that further raise blood pressure such as the three best-known ones: smoking, being overweight, and drinking too much alcohol.

Stress on the heart is terribly bad for you, but it rarely makes the headlines. We all know stress remains unhealthy for both our body and mind, but do we listen? More importantly, do we take action to prevent stress from causing disease in our bodies?

Despite decades of studies, we like to point fingers at the usual subjects. Smoking has the worst reputation of all. How many times have you tried to convince a loved one that smoking may take their life one day? They tell you they do it to calm their nerves, right? You beg them to take a walk instead; you suggest exercise classes and fishing at the lake. You may have printed out studies to show them what those commercially-made cigarettes and nightly booze binges will do to them. Maybe you are helping them avoid the dreaded black lungs we’ve seen in health class photos.

Yet, hold on. We’re talking about heart disease here.

Smoking is bad for your health, and often times fatal in terms of lung disease. But one of the longest running studies on heart disease contradicts what we all assumed about smoking and CHD. In the study, smokers developed fewer cases of CHD than non-smokers.

A much bigger risk factor is not smoking, but stress—the kind of stress found in a particular personality type—and when left unchecked, the manifestation of it can be worse on the heart than smoking.

According to Dr. Yuhong Dong, medical doctor and Ph.D. in infectious diseases, there are many biological and energetic mechanisms occurring concurrently in CHD, but the Type A personality’s unhealthy expression of anger is what makes a larger imprint on our hearts and minds.

A Surprising Risk Factor of Coronary Heart Diseases (CHD)

A counterintuitive twist on smoking’s effect on CHD brings to mind the story of Batuli Lamichhane, one of the oldest women in the world, who told news reporters on her 112th birthday that the secret to a long life is smoking, as she had puffed away on 30 cigarettes a day since she was 17 years old. If her story was just an isolated story that would be one thing, but it’s not. There are stories about many of the oldest people in the world who smoke, drink, and eat to their hearts’ content.

The Framingham project, which began in 1948, is the quintessential epidemiological and largest population study of more than 14,000 people across three generations. The project ultimately found evidence that formed the textbook warning we hear at doctor visits: high blood pressure and high blood cholesterol are major risk factors for CHD. However, we have learned something else from the well-known Framingham Heart Study.

The key lifestyle advice is hidden in the 1980s analysis of the final cohort.

When researchers looked at the long-term patterns in the cardiovascular health of more than 5,000 male and female smokers and non-smokers, consisting of 2,282 men and 2,845 women aged 29 through 62 years (and free from CHD at the initial examination), they found little evidence that smoking is a risk factor for coronary heart disease (CHD).

“In these monumental studies and analysis, smokers and non-smokers showed no differences at all,” said Dr. Dong. “CHD is the product of many risk factors acting synergistically. There is no doubt that smoking is one of many risk factors, but its effects, acting by itself, have been exaggerated.”

Dong said there may be even more to the Framingham Study. Evidence now shows that psychosocial factors, including having a stressed-wired personality, or Type A personality, are more predictive for heart disease than smoking. Even more predictive of CHD is how the Type A personality copes with stress. If Type A’s constantly cope with stress in angry, aggressive, and hostile ways, their odds for getting CHD increase exponentially.

Do You Have Traits of a Type A personality?

Do you feel guilty if you use free time to relax? Do you need to win in order to enjoy games and sports? Do you eat, walk, and move rapidly? Do you try to do more than one thing at a time? Have your loved ones and co-workers told you more than a few times that you need to calm down, mellow out, or take it easy?

You may be a “Type A” personality, or have a Type A behavior pattern (TABP). As much as you get things done and people can count on you to work hard, your health might suffer if you take your high achievement, competitiveness, and impatience too far. Some people can take on multiple projects and carry the weight of the world with grace, but most Type A’s do not.

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