Competitiveness in women is associated with increased all-cause and CVD mortality, but speed in men reduces risk of CVD mortality

T Lohse; S Rohrmann; A Richard; M Bopp; D Fäh; JP Krieger

doi:10.1055/s-0037-1605959

Das Gesundheitswesen, Table of Contents

Gesundheitswesen 2017; 79(08/09): 656-804
DOI: 10.1055/s-0037-1605959

Poster

Georg Thieme Verlag KG Stuttgart · New York

Competitiveness in women is associated with increased all-cause and CVD mortality, but speed in men reduces risk of CVD mortality

Authors

T Lohse

¹Universität Zürich, Institut für Epidemiologie, Biostatistik und Prävention, Zürich
S Rohrmann

¹Universität Zürich, Institut für Epidemiologie, Biostatistik und Prävention, Zürich
A Richard

¹Universität Zürich, Institut für Epidemiologie, Biostatistik und Prävention, Zürich
M Bopp

¹Universität Zürich, Institut für Epidemiologie, Biostatistik und Prävention, Zürich
D Fäh

¹Universität Zürich, Institut für Epidemiologie, Biostatistik und Prävention, Zürich
JP Krieger

¹Universität Zürich, Institut für Epidemiologie, Biostatistik und Prävention, Zürich

Abstract

Full Text

Background:

Type A behavior pattern (TABP) has been discussed as a possible risk factor for cardiovascular disease (CVD). However, studies showed mixed results, which might be partly due to not examining the underlying traits separately.

Aim:

We investigated the association between mortality and the Bortner Scale, a measure of TABP. Thereby, we took also its subscales competitiveness and speed into account.

Methods:

At baseline, information on the Bortner Scale and covariates of 9921 adult participants (aged ≥18 years) was collected. Data of two cross-sectional studies was pooled and linked with mortality information. The follow-up was up to 37 years. By applying Cox regression models, we analyzed whether the Bortner Scale and its two subscales competitiveness and speed were associated with all-cause, CVD, and specific CVD type mortality. Therefore, the Bortner Scale and its subscales were categorized into three categories, using the 25th and the 75th percentile as cut-off points.

Results:

We observed 3469 deaths, including 1118 CVD deaths. The entire Bortner Scale was not associated with mortality, but its subscales. For competitiveness in women, a positive association was shown with all-cause mortality (highest category vs. the lowest, HR 1.25 [95% CI 1.08,1.44]), CVD mortality (1.39 [1.07,1.81]), and ischemic heart disease mortality (intermediate category vs. the lowest, 1.46 [1.02,2.10]). In men, CVD mortality was inversely associated with speed (highest category vs. the lowest, 0.74 [0.59,0.93]).

Conclusions:

The subscales competitiveness and speed of the Bortner Scale were shown to be associated with CVD mortality in an opposed manner. This indicates that future studies using the Bortner Scale should apply the subscale analysis approach, considering differences by sex. Behavioral counseling in competitive women might offer the potential to reduce their risk of all-cause and CVD mortality.