Washington, Aug 18 Peripheral arterial disease patients with negative, inhibited personality type are at an increased risk of dying within four years, say researchers.

Peripheral arterial disease (PAD) occurs when plaque builds up in arteries that supply blood to body areas other than the heart and brain, such as the extremities.

However, patients with PAD also have an increased risk of secondary events such as stroke, heart attack and death, according to background information in the article.

According to the authors, preliminary evidence has suggested that personality traits such as hostility may also be associated with the severity and progression of atherosclerosis [plaque buildup] in patients with PAD.

However, another potential individual risk factor in this context is the distressed personality type (type D).

Type D refers to the joint tendency to experience negative emotions and to inhibit self-expression in social interaction.

In the study, Dr Annelies E. Aquarius, of Tilburg University, Tilburg, the Netherlands looked at 184 patients (average age 64.8) with peripheral arterial disease.

During four years of follow-up, 16 patients (8.7 percent) died, including seven who died of cancer and six of cardiovascular disease.

But after adjusting for age, sex, diabetes and kidney disease, patients with type D personality had an increased odds of death.

The personality type has been associated with increased activation of the immune system and changes in the body's stress response system.

In addition, "inadequate self-management of chronic disease is a potential behavioral mechanism that may explain the relation between type D personality and poor prognosis in cardiovascular disease," the authors said.

The study appears in Archives of Surgery, one of the JAMA/Archives journals. (ANI)