Being more optimistic lowers the risk of CVD and early death: JAMA

USA: Having a positive or optimistic outlook has always been linked to good overall health. Now, a recent study published in JAMA Network Open has revealed the benefit of optimism for heart health. According to the study, being optimistic lowers the risk of cardiovascular events and all-cause mortality. Also, the promotion of optimism and reduction in pessimism may be important for preventive health.

Negative emotions, social factors, and certain stress conditions have been known to be linked to adverse cardiac outcomes. However, the potential association between positive and negative mindsets and cardiac risk has not been studied in detail until now. Such research is of interest because mindsets are potentially modifiable that makes them a novel relevant target for clinical intervention. One such mindset is optimism -- defined as the tendency to have a positive outlook for future happenings in life.

Previous studies have shown optimism to be linked to favourable physical health outcomes and success in all forms of life endeavours. Nevertheless, the assessment of optimism and pessimism in cardiac medical practice is uncommon. Alan Rozanski, Mount Sinai St. Luke's Hospital, New York, New York, and colleagues conducted a meta-analysis and systematic review of the association between optimism and risk for future cardiovascular events and all-cause mortality.

The researchers searched the online databases from inception through July 2, 2019, to identify all cohort studies investigating the association between optimism and pessimism and cardiovascular events and/or all-cause mortality. The search yielded 15 studies comprising 229 391 participants of which 10 studies reported data on cardiovascular events and 9 studies reported data on all-cause mortality. The mean follow-up period was 13.8 years (range, 2-40 years).

Key findings of the study include:

• On pooled analysis, optimism was significantly associated with a decreased risk of cardiovascular events (relative risk, 0.65), with high heterogeneity in the analysis (I² = 87.4%).


• Similarly, optimism was significantly associated with a lower risk of all-cause mortality (relative risk, 0.86), with moderate heterogeneity (I² = 73.2%).


• Subgroup analyses by methods for assessment, follow-up duration, sex, and adjustment for depression and other potential confounders yielded similar results.

" Taken together, the cardiovascular and psychological benefits of optimism make it an attractive new arena for study within the field of behavioral cardiology," wrote the authors.

"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," concluded the authors.

The study, "Association of Optimism With Cardiovascular Events and All-Cause Mortality: A Systematic Review and Meta-analysis," is published in the JAMA Network Open.

DOI: 10.1001/jamanetworkopen.2019.12200