Type D personality: the heart, stress, and cortisol

Many studies have demonstrated the role of psychosocial and behavioural risk factors in the aetiology and pathogenesis of cardiovascular disorders. Recently, a new personality construct, the type D or ‘distressed’ personality, has been proposed.


 Type D behaviour is characterized by the joint tendency to experience negative emotions and to inhibit these emotions while avoiding social contacts with others. The observation that cardiac patients with type D personality are at increased risk for cardiovascular morbidity and mortality underlines the importance of examining both acute (e.g. major depression) and chronic (e.g. certain personality features) factors in patients at risk for coronary events. Both type D dimensions (negative affectivity and social inhibition) are associated with greater cortisol reactivity to stress. Elevated cortisol may be a mediating factor in the association between type D personality and the increased risk for coronary heart disease and, possibly, other medical disorders.

The following statement is not true about sotalol:

1. It is a non-selective beta blocker.
2. It prolongs action potential duration throughout the heart.
3. It is excreted through bile following hepatic metabolism.
4. Polymorhpic ventricular tachycardia is a common side-effect.

Which of the following statements about hydralazine is NOT true?

1. It causes direct relaxation of the blood vessels.
2. It causes dilatation of both arteries and veins.
3. Postural hypotension is not a common problem.
4. It increases plasma renin activity.

Which of the following does not result in the release of NO?

1. Fenoldopam.
2. Hydralazine.
3. Nitroprusside.
4. Nitroglycerine.

True about fibrates are all except

1. Drug of choice fro Type III hyperlipoproteinemia and severe hypertriglyceridemia.
2. Activate PPAR to stimulate LPL.
3. Absorbed good on empty stomach and absorption is delayed by fatty meals.
4. Side effect are rash, urticaria, myalgia and impotence.

Coronary steal phenomenon is seen with

1. Dipyridamole.
2. Dilitiazem.
3. Propanolol.
4. Verapamil.

All are used for treatment of pulmonary hypertension except

1. Endothelin receptor antagonists.
2. Phosphodiesterase antagonists.
3. Calcium channel blockers.
4. Beta blockers.

Angiotensin II causes all except

1. Stimulates release of ADH
2. Increases thirst.
3. Vasodilation
4. Stimulates aldosterone release.