Type D personality is associated with low cardiovascular reactivity to acute mental stress in heart failure patients

Background: The distressed (Type D) personality is associated with adverse coronary heart disease outcomes, but the mechanisms accounting for this association remain to be elucidated. We examined whether myocardial and hemodynamic responses to mental stress are disrupted in Type D patients with chronic heart failure (HF). Methods: Ninety-nine HF patients (mean age 65 12 years; 75% men) underwent a public speech task, during which heart rate (HR) and blood pressure (BP) were recorded. Type D personality and its components negative affectivity (NA) and social inhibition (SI) were assessed with the DS14. General linear models with repeated measures and logistic regression were used to assess differences in stress response and recovery. Results: Type D personality was associated with a reduced HR response (F-1,F-93=4.31, p<.05) independent of the use of beta adrenergic blocking agents and the presence of atrial fibrillation. There were no differences between HF patients with and without a Type D personality with respect to the BP response. Examining continuous NA and SI scores and their interaction (NA*SI), revealed a significant association of NA*SI with the SBP response (F-1,F-93=4.11, p<.05), independent of BP covariates. Results with respect to HR and DBP responses were comparable to the findings using the dichotomous Type D measure. No significant associations between Type D and recovery patterns were found. Conclusion: HF patients with Type D personality may show an inadequate response to acute social stress, characterized by a blunted HR response. (C) 2013 Elsevier B.V. All rights reserved.