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Optimistic mindset could have positive impact on CV risk, mortality
Researchers reported that optimism, compared with pessimism, is associated with a reduced risk for CV events and all-cause mortality.
According to a study published in JAMA Network Open, a meta-analysis of 15 studies that assessed the effects of optimism or pessimism on CV events and mortality showed that optimism was significantly associated with reduced risk for CV events (RR = 0.65; 95% CI, 0.51-0.78) and all-cause mortality (RR = 0.86; 95% CI, 0.8-0.92).
The studies included in this meta-analysis utilized the Life Orientation Test-Revised scale, Minnesota Multiphasic Personality Inventory or single-item measures to assess optimism and pessimism. Therefore, the CV event assessment had high heterogeneity (I2 = 87.4%) and the mortality analysis showed moderate heterogeneity (I2 = 73.2%).
“Optimism has long been promulgated as a positive attribute for living,” Alan Rozanski, MD, professor of medicine and cardiology in the department of cardiology at Mount Sinai St. Luke’s Hospital, and colleagues wrote. “The findings of the current meta-analysis suggest that optimism is associated with cardiovascular benefits and that pessimism is associated with cardiovascular risk, with a pooled association that was similar to that for well-established cardiac risk factors. Taken together, the cardiovascular and psychological benefits of optimism make it an attractive new arena for study within the field of behavioral cardiology.”
To obtain data for this meta-analysis, researchers systematically searched PubMed, Scopus and PsycINFO databases using terms such as optimism, pessimism, outcomes, endpoint, mortality, CV events, stroke, CHD, ischemic heart disease and CVD. Studies were selected for analysis if they met the inclusion criteria of assessing associations of optimism with all-cause mortality, CV events and reported adjusted HR with 95% CI. All included studies were empirical.
“The findings suggest that optimism is associated with a lower risk of cardiovascular events and all-cause mortality,” the researchers wrote. “Future studies should seek to better define the biobehavioral mechanisms underlying this association and evaluate the potential benefit of interventions designed to promote optimism or reduce pessimism.”
In a related editorial published in JAMA Network Open, Jeff C. Huffman, MD, director of the cardiac psychiatry research program at Massachusetts General Hospital, wrote: “The specific construct that has been most consistently associated with medical health outcomes is dispositional optimism, measured by the Life Orientation Test-Revised. This is an important issue, given that optimism as conceptualized by this scale is a largely stable trait, as opposed to potentially more modifiable optimism-related constructs, such as positive expectancies or state optimism. If it is largely a person’s inherent optimistic nature from which they derive health benefit, such a trait may be difficult to modify with an intervention.” – by Scott Buzby
Disclosures: The authors report no relevant financial disclosures. Huffman reports he received research funding from the NIH and the American Diabetes Association to study well-being interventions in patients with medical illness.