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72-402: (Redirected from Type-D ) Type D or D-Type may refer to: Science [ edit ] D-type asteroid Type D personality , a concept used in the field of medical psychology Petrov type D , an algebraic classification Technology [ edit ] Type D plug, a type of electrical power plug Type-D destroyer , ships of

144-417: A coronary care unit for possible complications (such as cardiac arrhythmias – irregularities in the heart rate). Depending on the risk assessment, stress testing or angiography may be used to identify and treat coronary artery disease in patients who have had an NSTEMI or unstable angina. There are various risk assessment systems for determining the risk of coronary artery disease, with various emphasis on

216-619: A healthy diet , regularly exercising , maintaining a healthy weight, and not smoking. Medications for diabetes, high cholesterol, or high blood pressure are sometimes used. There is limited evidence for screening people who are at low risk and do not have symptoms. Treatment involves the same measures as prevention. Additional medications such as antiplatelets (including aspirin ), beta blockers , or nitroglycerin may be recommended. Procedures such as percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) may be used in severe disease. In those with stable CAD it

288-453: A valid and reliable 14-item questionnaire, the Type D Scale (DS14). Seven items refer to negative affectivity, and seven items refer to social inhibition. People who score 10 points or more on both dimensions are classified as Type D. Both negative affectivity and social inhibition have been shown to be relatively stable traits across four years. The DS14 can be applied in clinical practice for

360-775: A Type D personality have a worse prognosis following a myocardial infarction (MI) as compared to patients without a Type D personality. In some of these studies, Type D was associated with a 4-fold increased risk of mortality, recurrent MI, or sudden cardiac death , independently of traditional risk factors, such as disease severity. However, a number of subsequent, larger scale studies have failed to replicate these findings. Consequently, some researchers have argued that these earlier, small (and therefore potentially statistically underpowered) studies that appeared to link Type D personality to mortality in CAD and CVD patients may have inadvertently reached exaggerated or false conclusions. Indeed,

432-416: A causal effect of type D personality from an effect of only one of the underlying personality traits negative affectivity or social inhibition. The continuous interaction method does not classify individuals in personality groups, but includes the negative affectivity and social inhibition scores as predictors in the statistical model. The interaction effect between negative affectivity and social inhibition

504-656: A combination of genetic predisposition and environmental factors. Organizations such as the Indian Heart Association are working with the World Heart Federation to raise awareness about this issue. Coronary artery disease is the leading cause of death for both males and females and accounts for approximately 600,000 deaths in the United States every year. According to present trends in the United States, half of healthy 40-year-old males will develop CAD in

576-405: A given age also decreased between 1990 and 2010. In the United States in 2010, about 20% of those over 65 had CAD, while it was present in 7% of those 45 to 64, and 1.3% of those 18 to 45; rates were higher among males than females of a given age. The most common symptom is chest pain or discomfort that occurs regularly with activity, after eating, or at other predictable times; this phenomenon

648-490: A heart attack or myocardial infarction, and immediate emergency medical services are crucial. With advanced disease, the narrowing of coronary arteries reduces the supply of oxygen-rich blood flowing to the heart, which becomes more pronounced during strenuous activities during which the heart beats faster and has an increased oxygen demand. For some, this causes severe symptoms, while others experience no symptoms at all. Symptoms in females can differ from those in males, and

720-495: A high-powered individual patient data meta-analysis including data from 19 previously published prospective cohort studies, involving more than 11.000 CVD patients, found evidence that Type D is not a risk factor for mortality in CVD patients, while strong evidence was found for Type D personality as a risk factor for the occurrence of adverse events during a median follow-up time of 48 months. Type D personality can be assessed by means of

792-404: A motorcycle Audi Type D , a car Auto Union Type D , a Grand Prix racing car See also [ edit ] Class D (disambiguation) Model D (disambiguation) Topics referred to by the same term [REDACTED] This disambiguation page lists articles associated with the title Type D . If an internal link led you here, you may wish to change the link to point directly to

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864-431: A myocardial infarction but does not change the overall risk of death. Aspirin therapy to prevent heart disease is thus recommended only in adults who are at increased risk for cardiovascular events, which may include postmenopausal females, males above 40, and younger people with risk factors for coronary heart disease, including high blood pressure , a family history of heart disease, or diabetes . The benefits outweigh

936-404: A neuropsychological assessment. There are a number of treatment options for coronary artery disease: It is recommended that blood pressure typically be reduced to less than 140/90 mmHg. The diastolic blood pressure however should not be lower than 60 mmHg. Beta-blockers are recommended first line for this use. In those with no previous history of heart disease, aspirin decreases the risk of

1008-427: A role. The diagnosis of CAD depends largely on the nature of the symptoms and imaging. The first investigation when CAD is suspected is an electrocardiogram (ECG/EKG), both for stable angina and acute coronary syndrome. An X-ray of the chest , blood tests and resting echocardiography may be performed. For stable symptomatic patients, several non-invasive tests can diagnose CAD depending on pre-assessment of

1080-558: A safe and feasible procedure that may offer some advantages over conventional CABG though it is more expensive. As of 2010, CAD was the leading cause of death globally resulting in over 7 million deaths. This increased from 5.2 million deaths from CAD worldwide in 1990. It may affect individuals at any age but becomes dramatically more common at progressively older ages, with approximately a tripling with each decade of life. Males are affected more often than females. The World Health Organization reported that: "The world's biggest killer

1152-416: A significant role in stiffening the arteries and inducing the early phase of coronary arteriosclerosis . This can be seen in a so-called metastatic mechanism of calciphylaxis as it occurs in chronic kidney disease and hemodialysis . Although these people have kidney dysfunction, almost fifty percent of them die due to coronary artery disease. Plaques can be thought of as large "pimples" that protrude into

1224-471: A type D group when they score 10 or higher on both the NA and SI total scores and those with all other score patterns in a non-type D group. A variables classifying individuals in one of these two groups is then used in further statistical analysis. Various researchers have criticised this two-group method, not only for resulting in less statistical power but also for risking spurious type D effects. A four-group method

1296-417: Is a type of heart disease involving the reduction of blood flow to the cardiac muscle due to a build-up of atheromatous plaque in the arteries of the heart . It is the most common of the cardiovascular diseases . CAD can cause stable angina , unstable angina , myocardial ischemia, and myocardial infarction . A common symptom is angina, which is chest pain or discomfort which may travel into

1368-570: Is another way of risk assessment. In one study the relative risk of incident coronary events was 91% higher among participants at high genetic risk than among those at low genetic risk. Up to 90% of cardiovascular disease may be preventable if established risk factors are avoided. Prevention involves adequate physical exercise , decreasing obesity , treating high blood pressure , eating a healthy diet , decreasing cholesterol levels, and stopping smoking . Medications and exercise are roughly equally effective. High levels of physical activity reduce

1440-410: Is available. In the absence of ST-segment elevation, heart damage is detected by cardiac markers (blood tests that identify heart muscle damage). If there is evidence of damage ( infarction ), the chest pain is attributed to a "non-ST elevation MI" (NSTEMI). If there is no evidence of damage, the term "unstable angina" is used. This process usually necessitates hospital admission and close observation on

1512-507: Is called a myocardial infarction (commonly referred to as a heart attack). It leads to damage, death, and eventual scarring of the heart muscle without regrowth of heart muscle cells. Chronic high-grade narrowing of the coronary arteries can induce transient ischemia which leads to the induction of a ventricular arrhythmia , which may terminate into a dangerous heart rhythm known as ventricular fibrillation , which often leads to death. Typically, coronary artery disease occurs when part of

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1584-503: Is characterized by heart problems that result from atherosclerosis. Atherosclerosis is a type of arteriosclerosis which is the "chronic inflammation of the arteries which causes them to harden and accumulate cholesterol plaques (atheromatous plaques) on the artery walls". CAD has several well-determined risk factors that contribute to atherosclerosis. These risk factors for CAD include "smoking, diabetes, high blood pressure (hypertension), abnormal (high) amounts of cholesterol and other fat in

1656-415: Is found in cardiac muscle; it is a 'cytolinker' that connects actin and desmin to facilitate cytoskeletal function and vesicular movement. The endocytic pathway is further modulated by changes in tubulin , a key microtubule protein, and fidgetin , a tubulin-severing enzyme that is a marker for cardiovascular risk identified by genome-wide association study . Protein recycling would be modulated by changes in

1728-491: Is inferior to non-invasive imaging methods due to the risk of false negative and false positive test results. The use of non-invasive imaging is not recommended on individuals who are exhibiting no symptoms and are otherwise at low risk for developing coronary disease. Invasive testing with coronary angiography (ICA) can be used when non-invasive testing is inconclusive or show a high event risk. The diagnosis of microvascular angina (previously known as cardiac syndrome X –

1800-453: Is ischemic heart disease, responsible for 13% of the world's total deaths. Since 2000, the largest increase in deaths has been for this disease, rising by 2.7 million to 9.1 million deaths in 2021." It is estimated that 60% of the world's cardiovascular disease burden will occur in the South Asian subcontinent despite only accounting for 20% of the world's population. This may be secondary to

1872-687: Is linked to an increased risk of coronary disease. The consumption of different types of fats including trans fat (trans unsaturated), and saturated fat , in a diet "influences the level of cholesterol that is present in the bloodstream". Unsaturated fats originate from plant sources (such as oils). There are two types of unsaturated fats, cis and trans isomers. Cis unsaturated fats are bent in molecular structure and trans are linear in structure. Saturated fats originate from animal sources (such as animal fats) and are also molecularly linear in structure. The linear configurations of unsaturated trans and saturated fats allow them to easily accumulate and stack at

1944-465: Is more effective than hemoglobin A1c (HbA1c) for detecting dysglycemia in patients with coronary artery disease. The study highlighted that 2-hour post-load glucose levels of at least 9 mmol/L were strong predictors of cardiovascular outcomes, while HbA1c levels of at least 5.9% were also significant but not independently associated when combined with OGTT results. A diet high in fruits and vegetables decreases

2016-489: Is most commonly used to provide rapid relief for acute angina attacks and as a complement to anti-anginal treatments in patients with refractory and recurrent angina. When nitroglycerine enters the bloodstream, it forms free radical nitric oxide, or NO, which activates guanylate cyclase and in turn stimulates the release of cyclic GMP. This molecular signaling stimulates smooth muscle relaxation, ultimately resulting in vasodilation and consequently improved blood flow to regions of

2088-533: Is no evidence that they change mortality, the risk of revascularization procedures, or the rate of non-fatal myocardial infarction. Antibiotics for secondary prevention of coronary heart disease Early studies suggested that antibiotics might help patients with coronary disease to reduce the risk of heart attacks and strokes. However, a 2021 Cochrane meta-analysis found that antibiotics given for secondary prevention of coronary heart disease are harmful for people with increased mortality and occurrence of stroke. So,

2160-626: Is preventing further sequelae of already established disease. Effective lifestyle changes include: Aerobic exercise , like walking, jogging, or swimming, can reduce the risk of mortality from coronary artery disease. Aerobic exercise can help decrease blood pressure and the amount of blood cholesterol (LDL) over time. It also increases HDL cholesterol. Although exercise is beneficial, it is unclear whether doctors should spend time counseling patients to exercise. The U.S. Preventive Services Task Force found "insufficient evidence" to recommend that doctors counsel patients on exercise but "it did not review

2232-541: Is termed stable angina and is associated with narrowing of the arteries of the heart . Angina also includes chest tightness, heaviness, pressure, numbness, fullness, or squeezing. Angina that changes in intensity, character or frequency is termed unstable. Unstable angina may precede myocardial infarction . In adults who go to the emergency department with an unclear cause of pain, about 30% have pain due to coronary artery disease. Angina, shortness of breath, sweating, nausea or vomiting, and lightheadedness are signs of

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2304-433: Is then tested to investigate whether the two personality traits synergistically affect an outcome. If there is an interaction effect between negative affectivity and social inhibition on the outcome, then the effect of these traits is not constant, but the effect of one trait changes across scores on the other trait. If the interaction effect is positive, then the effect of one trait on the outcome increases for higher scores on

2376-434: Is unclear if PCI or CABG in addition to the other treatments improves life expectancy or decreases heart attack risk. In 2015, CAD affected 110 million people and resulted in 8.9 million deaths. It makes up 15.6% of all deaths, making it the most common cause of death globally. The risk of death from CAD for a given age decreased between 1980 and 2010, especially in developed countries . The number of cases of CAD for

2448-576: The Imperial Japanese Navy Type D escort ship , ships of the Imperial Japanese Navy Type D submarine , submarines of the Imperial Japanese Navy Avro Type D , a 1911 aircraft Caudron Type D , a 1911 aircraft Blackburn Type D , a 1912 aircraft Handley Page Type D , a 1910 aircraft D type Adelaide tram Motor vehicles [ edit ] Jaguar D-Type , a sports racing car Honda D-Type ,

2520-413: The arterial walls when consumed in high amounts (and other positive measures towards physical health are not met). High levels of cholesterol in the bloodstream lead to atherosclerosis. With increased levels of LDL in the bloodstream, "LDL particles will form deposits and accumulate within the arterial walls, which will lead to the development of plaques, restricting blood flow". The resultant reduction in

2592-543: The blood (dyslipidemia), type 2 diabetes and being overweight or obese (having excess body fat)" due to lack of exercise and a poor diet. Some other risk factors include high blood pressure , smoking , diabetes , lack of exercise, obesity , high blood cholesterol , poor diet, depression , family history , psychological stress and excessive alcohol . About half of cases are linked to genetics. Smoking and obesity are associated with about 36% and 20% of cases, respectively. Smoking just one cigarette per day about doubles

2664-573: The bone morphogenic proteins are members of the TGF-beta superfamily, and likewise impact Treg differentiation. Several of the transcripts ( TMEM98 , NRCAM , SFRP5 , SHISA2 ) are elements of the Wnt signaling pathway, which is a major determinant of Treg differentiation. Limitation of blood flow to the heart causes ischemia (cell starvation secondary to a lack of oxygen) of the heart's muscle cells . The heart's muscle cells may die from lack of oxygen and this

2736-473: The channel of an artery, causing partial obstruction to blood flow. People with coronary artery disease might have just one or two plaques or might have dozens distributed throughout their coronary arteries . A more severe form is chronic total occlusion (CTO) when a coronary artery is completely obstructed for more than 3 months. Microvascular angina is a type of angina pectoris in which chest pain and chest discomfort occur without signs of blockages in

2808-464: The circulating immune system would be related to the immune synapse . One of the most differentially expressed genes, fibromodulin (FMOD), which is increased 2.8-fold in CAD, is found mainly in connective tissue and is a modulator of the TGF-beta signaling pathway. However, not all of the RNA changes may be related to the immune synapse. For example, Nebulette , the most down-regulated transcript (2.4-fold),

2880-420: The construct based on clinical observations in cardiac patients, empirical evidence , and existing theories of personality . The prevalence of Type D personality is 21% in the general population and ranges between 18% and 53% in cardiac patients. Type D has also been addressed with respect to common somatic complaints in childhood. Some early studies found that coronary artery disease (CAD) patients with

2952-409: The diameter of their blood vessels, leading to decreased progression of atherosclerosis. In contrast, females who had high levels of work-related stress experienced a decrease in the diameter of their blood vessels and significantly increased disease progression. Having a type A behavior pattern , a group of personality characteristics including time urgency, competitiveness, hostility, and impatience,

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3024-533: The different variables above. A notable example is Framingham Score , used in the Framingham Heart Study . It is mainly based on age, gender, diabetes, total cholesterol, HDL cholesterol, tobacco smoking, and systolic blood pressure. When predicting risk in younger adults (18–39 years old), the Framingham Risk Score remains below 10–12% for all deciles of baseline-predicted risk. Polygenic score

3096-421: The evidence for the effectiveness of physical activity to reduce chronic disease, morbidity, and mortality", only the effectiveness of counseling itself. The American Heart Association , based on a non-systematic review, recommends that doctors counsel patients on exercise. Psychological symptoms are common in people with CHD, and while many psychological treatments may be offered following cardiac events, there

3168-793: The evidence is weak. Specifically, its use does not change the risk of death in this group. In those who have had a stent, more than 12 months of clopidogrel plus aspirin does not affect the risk of death. Revascularization for acute coronary syndrome has a mortality benefit. Percutaneous revascularization for stable ischaemic heart disease does not appear to have benefits over medical therapy alone. In those with disease in more than one artery, coronary artery bypass grafts appear better than percutaneous coronary interventions . Newer "anaortic" or no-touch off-pump coronary artery revascularization techniques have shown reduced postoperative stroke rates comparable to percutaneous coronary intervention. Hybrid coronary revascularization has also been shown to be

3240-436: The harms most favorably in people at high risk for a cardiovascular event, where high risk is defined as at least a 3% chance over a five-year period, but others with lower risk may still find the potential benefits worth the associated risks. Clopidogrel plus aspirin (dual anti-platelet therapy) reduces cardiovascular events more than aspirin alone in those with a STEMI . In others at high risk but not having an acute event,

3312-450: The heart affected by atherosclerotic plaque. Stable coronary artery disease (SCAD) is also often called stable ischemic heart disease (SIHD). A 2015 monograph explains that "Regardless of the nomenclature, stable angina is the chief manifestation of SIHD or SCAD." There are U.S. and European clinical practice guidelines for SIHD/SCAD. In patients with non-severe asymptomatic aortic valve stenosis and no overt coronary artery disease,

3384-466: The heart muscle). Diagnosis is clear-cut if ECGs show elevation of the " ST segment ", which in the context of severe typical chest pain is strongly indicative of an acute myocardial infarction (MI); this is termed a STEMI (ST-elevation MI) and is treated as an emergency with either urgent coronary angiography and percutaneous coronary intervention (angioplasty with or without stent insertion) or with thrombolysis ("clot buster" medication), whichever

3456-428: The heart muscle). If part of the heart seems to receive an insufficient blood supply, coronary angiography may be used to identify stenosis of the coronary arteries and suitability for angioplasty or bypass surgery . In minor to moderate cases, nitroglycerine may be used to alleviate acute symptoms of stable angina or may be used immediately before exertion to prevent the onset of angina. Sublingual nitroglycerine

3528-783: The heart's blood supply due to atherosclerosis in coronary arteries "causes shortness of breath, angina pectoris (chest pains that are usually relieved by rest), and potentially fatal heart attacks (myocardial infarctions)". The heritability of coronary artery disease has been estimated between 40% and 60%. Genome-wide association studies have identified over 160 genetic susceptibility loci for coronary artery disease. Several RNA Transcripts associated with CAD - FoxP1 , ICOSLG , IKZF4/Eos , SMYD3 , TRIM28 , and TCF3/E2A are likely markers of regulatory T cells (Tregs), consistent with known reductions in Tregs in CAD. The RNA changes are mostly related to ciliary and endocytic transcripts, which in

3600-512: The immune synapse, there were numerous transcripts that related directly to T cell function and the control of differentiation. Butyrophilin is a co-regulator for T cell activation. Fibromodulin is a modulator of the TGF-beta signaling pathway, a primary determinant of Tre differentiation. Further impact on the TGF-beta pathway is reflected in concurrent changes in the BMP receptor 1B RNA (BMPR1B), because

3672-428: The increased troponin T (above 14 pg/mL) was found associated with an increased 5-year event rate of ischemic cardiac events ( myocardial infarction , percutaneous coronary intervention , or coronary artery bypass surgery ). Diagnosis of acute coronary syndrome generally takes place in the emergency department , where ECGs may be performed sequentially to identify "evolving changes" (indicating ongoing damage to

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3744-673: The intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=Type_D&oldid=1223421590 " Category : Disambiguation pages Hidden categories: Short description is different from Wikidata All article disambiguation pages All disambiguation pages Type D personality Individuals with a Type D personality have the tendency to experience increased negative emotions across time and situations and tend not to share these emotions with others, because of fear of rejection or disapproval. Johan Denollet, professor of Medical Psychology at Tilburg University , Tilburg , The Netherlands , developed

3816-404: The larger coronary arteries of their hearts when an angiogram (coronary angiogram) is being performed. The exact cause of microvascular angina is unknown. Explanations include microvascular dysfunction or epicardial atherosclerosis. For reasons that are not well understood, females are more likely than males to have it; however, hormones and other risk factors unique to females may play

3888-633: The most common symptom reported by females of all races is shortness of breath. Other symptoms more commonly reported by females than males are extreme fatigue, sleep disturbances, indigestion, and anxiety. However, some females experience irregular heartbeat, dizziness, sweating, and nausea. Burning, pain, or pressure in the chest or upper abdomen that can travel to the arm or jaw can also be experienced in females, but females less commonly report it than males. Generally, females experience symptoms 10 years later than males. Females are less likely to recognize symptoms and seek treatment. Coronary artery disease

3960-412: The myocardium. Stable angina is short-term chest pain during physical exertion caused by an imbalance between myocardial oxygen supply and metabolic oxygen demand. Various forms of cardiac stress tests may be used to induce both symptoms and detect changes by way of electrocardiography (using an ECG), echocardiography (using ultrasound of the heart) or scintigraphy (using uptake of radionuclide by

4032-434: The other trait. Recent simulation studies have shown that the continuous interaction method is able to distinguish effects of type D personality from an effect of only one of the personality traits negative affectivity or social inhibition. When testing interaction effects between correlated continuous variables, it is recommended to investigate the potential non-linear effects of negative affectivity and social inhibition on

4104-409: The other trait. Such a positive interaction effect would be an example of synergy between negative affectivity and social inhibition because higher scores on both traits result in increasingly higher predicted values on the outcome measure. A negative interaction effects would not represent a synergistic effect because then the effect of one personality trait on the outcome decreases with higher scores on

4176-541: The outcome measure, because not including true non-linear effects in the model can cause spurious interaction effects. Ideally the continuous interaction method is modeled within a structural equation model to filter out individual differences due to measurement error when estimating the interaction between the latent variables negative affectivity and social inhibition. Coronary artery disease Coronary artery disease ( CAD ), also called coronary heart disease ( CHD ), or ischemic heart disease ( IHD ),

4248-416: The proteasomal regulator SIAH3 , and the ubiquitin ligase MARCHF10 . On the ciliary aspect of the immune synapse, several of the modulated transcripts are related to ciliary length and function. Stereocilin is a partner to mesothelin , a related super-helical protein, whose transcript is also modulated in CAD. DCDC2 , a double-cortin protein, is a modulator of ciliary length. In the signaling pathways of

4320-466: The rare coronary artery disease that is more common in females, as mentioned, is a diagnosis of exclusion. Therefore, usually, the same tests are used as in any person suspected of having coronary artery disease: Stable angina is the most common manifestation of ischemic heart disease, and is associated with reduced quality of life and increased mortality. It is caused by epicardial coronary stenosis which results in reduced blood flow and oxygen supply to

4392-460: The risk of CAD. Lack of exercise has been linked to 7–12% of cases. Exposure to the herbicide Agent Orange may increase risk. Rheumatologic diseases such as rheumatoid arthritis , systemic lupus erythematosus , psoriasis , and psoriatic arthritis are independent risk factors as well. Job stress appears to play a minor role accounting for about 3% of cases. In one study, females who were free of stress from work life saw an increase in

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4464-486: The risk of cardiovascular disease and death. Vegetarians have a lower risk of heart disease, possibly due to their greater consumption of fruits and vegetables. Evidence also suggests that the Mediterranean diet and a high fiber diet lower the risk. The consumption of trans fat (commonly found in hydrogenated products such as margarine ) has been shown to cause a precursor to atherosclerosis and increase

4536-541: The risk of coronary artery disease by about 25%. Life's Essential 8 are the key measures for improving and maintaining cardiovascular health, as defined by the American Heart Association. AHA added sleep as a factor influencing heart health in 2022. Most guidelines recommend combining these preventive strategies. A 2015 Cochrane Review found some evidence that counseling and education to bring about behavioral change might help in high-risk groups. However, there

4608-410: The risk of coronary artery disease. Evidence does not support a beneficial role for omega-3 fatty acid supplementation in preventing cardiovascular disease (including myocardial infarction and sudden cardiac death ). There is tentative evidence that intake of menaquinone ( Vitamin K 2 ), but not phylloquinone ( Vitamin K 1 ), may reduce the risk of CAD mortality . Secondary prevention

4680-492: The risk profile. Noninvasive imaging options include; Computed tomography angiography (CTA) (anatomical imaging, best test in patients with low-risk profile to "rule out" the disease), positron emission tomography (PET), single-photon emission computed tomography (SPECT)/nuclear stress test/myocardial scintigraphy and stress echocardiography (the three latter can be summarized as functional noninvasive methods and are typically better to "rule in"). Exercise ECG or stress test

4752-601: The risk stratification of cardiac patients. Various scholars have argued that the relation between Type D personality (high scores on negative affectivity and social inhibition) and an outcome can be conceptualised as a synergy between negative affectivity and social inhibition on the outcome of interest. Several methods have been used to statistically model the relation between Type D personality and an outcome measure. A crude distinction can be made between dimensional and typological approaches. Most earlier studies aimed to capture this synergistic effect by classifying people in

4824-875: The shoulder, arm, back, neck, or jaw. Occasionally it may feel like heartburn . In stable angina , symptoms occur with exercise or emotional stress , last less than a few minutes, and improve with rest. Shortness of breath may also occur and sometimes no symptoms are present. In many cases, the first sign is a heart attack . Other complications include heart failure or an abnormal heartbeat . Risk factors include high blood pressure , smoking , diabetes , lack of exercise, obesity , high blood cholesterol , poor diet, depression , and excessive alcohol consumption. A number of tests may help with diagnosis including: electrocardiogram , cardiac stress testing , coronary computed tomographic angiography , biomarkers ( high-sensitivity cardiac troponins ) and coronary angiogram , among others. Ways to reduce CAD risk include eating

4896-414: The smooth, elastic lining inside a coronary artery (the arteries that supply blood to the heart muscle) develops atherosclerosis . With atherosclerosis, the artery's lining becomes hardened, stiffened, and accumulates deposits of calcium, fatty lipids, and abnormal inflammatory cells – to form a plaque . Calcium phosphate (hydroxyapatite) deposits in the muscular layer of the blood vessels appear to play

4968-406: The use of antibiotics is not currently supported for preventing secondary coronary heart disease. A thorough systematic review found that indeed there is a link between a CHD condition and brain dysfunction in females. Consequently, since research is showing that cardiovascular diseases, like CHD, can play a role as a precursor for dementia, like Alzheimer's disease, individuals with CHD should have

5040-596: Was causally driving the effect. For instance, in some of these simulated data, only one personality trait (e.g., only negative affectivity) was causally related to an outcome. Analysing such data with the two-group and four-group methods often produced statistically significant effects of the type D group compared with the other groups, while no differences on the outcome are expected between those with Type D personality and those with only high negative affectivity. These simulation findings imply that estimated type D effects based on two or four personality groups cannot distinguish

5112-406: Was commonly applied to solve this issue by distinguishing individuals without Type D personality from those with high scores on either negative affectivity or social inhibition alone. Two recent computer simulation studies showed that both the two-group and four-group methods can indicate that Type D personality is related to an outcome, when in reality only one of the underlying personality traits

5184-492: Was insufficient evidence to show an effect on mortality or actual cardiovascular events. In diabetes mellitus , there is little evidence that very tight blood sugar control improves cardiac risk although improved sugar control appears to decrease other problems such as kidney failure and blindness . A 2024 study published in The Lancet Diabetes & Endocrinology found that the oral glucose tolerance test (OGTT)

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