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August 21, 1987

Leukocytes and the Risk of Ischemic Diseases

Author Affiliations

Massachusetts General Hospital Boston
Tufts University Boston

Massachusetts General Hospital Boston
Tufts University Boston

JAMA. 1987;258(7):907-908. doi:10.1001/jama.1987.03400070045016

To the Editor.—  We are writing in reference to the article concerning the role of the white blood cell (WBC) count as an independent predictor for the risk of ischemic diseases.1 The authors mention the possibility that the WBC count could merely be a marker for stress. To support their statement that stress is a cardiovascular risk factor associated with increased blood catecholamine levels and with an elevated WBC count, they quote an article by Friedman et al2 that not only does not mention leukocytes at all, but does not even mention the word stress. This article reports instead the results of a study on catecholamine secretion in the type A behavior pattern, an action/emotion complex characterized by aggressive and competitive drive and an enhanced sense of urgency.We are surprised that the authors did not consider the possibility that the type A behavior pattern, rather than stress,