Abstract
The Framingham study established cigarette smoking, elevated serum cholesterol, high systolic blood pressure and advancing age as risk factors for coronary
heart disease (Dawber, Meadors, & Moore, 1951). Knowledge about these risk
factors alone or in combination, however, still does not predict most new cases
of coronary heart disease (CHD) in the United States (Jenkins, 1976). Search for
additional risk factors, however, has led to identification by the Western Collaborative Group Study (WCGS) of the Type A coronary-prone behavior pattern as
a potential risk factor for CHD (Rosenman, Brand, Jenkins, Friedman, Strauss,
& Wurm, 1975). Although the Framingham study and the WCGS demonstrated
associations between particular risk factors and CHD, the exact pathophysiologic
mechanisms mediating the relationship between any risk factor and CHD are
presently unknown.