Type A behavior has been demonstrated to be as significant a predictor for heart attacks as high cholesterol, hypertension and smoking, and may contribute to these standard risk factors. Stress increases blood pressure, has a far more powerful effect on serum cholesterol than dietary fat intake, and many people smoke because they are under stress. It has certainly been suggested that certain Type A traits, particularly increased anger, hostility, and cynicism, may be particularly likely to cause heart attacks and sudden death. In addition, the ability to reduce Type A tendencies by behavioral modification may lower the likelihood of future coronary events.

Should individuals who demonstrate some Type A characteristics be concerned? After all, a certain amount of increased stress improves productivity. There are also good stresses. Winning a race or election may be just as stressful as losing -- or more so, but the emotional and physiological consequences may not be the same. A passionate kiss and contemplating what might ensue is stressful, by hardly the same feeling experienced during root canal work. It's hard to define stress because it can represent so many different things. Furthermore, the same event, like a roller coaster ride, may be terrifyingly distressful to some, but a pleasurable thrill to others. Nevertheless, all of laboratory and clinical research confirms that the feeling of having little control is always distressful, and that's what stress is all about. Type A's who are in control, take pride in what they produce, and are not hostile or prone to outbursts of anger, may lead very healthy lives.

Therefore a variety of attempts have been made to develop ways to detect and rate what is now called coronary prone Type A behavior. The most accurate method is by an interview designed to elicit characteristic traits, administered by a specially trained investigator, which is videotaped for careful review by experts. Self report questionnaires of varying lengths have also been devised. The problem is that Type A's are often unaware of their behavioral excesses, or will deny them. Family members, co-workers, and friends are apt to provide much more reliable information., These considerations should be kept in mind with respect to the following 10-item quiz. However, individuals with high scores, particularly for the last five items, might benefit from a more thorough evaluation.