February 28, 2006

Optimists Show Lower Risk of Heart Disease Death

By Amy Norton

NEW YORK -- Men with a bright outlook on life seem to be less likely to die of heart disease or stroke than their more pessimistic peers, Dutch researchers report.

The findings, published in the Archives of Internal Medicine, add to evidence that natural optimists may be a hardier breed. In an earlier study, the same researchers found a lower risk of death from any cause within a given timeframe among older adults who had generally optimistic attitudes.

The new study followed 545 men between the ages of 64 and 84 for up to 15 years. It found that those who were judged to be optimists at the outset, based on a 4-item questionnaire, were about half as likely to die of cardiovascular disease during follow-up as men who were more pessimistic by nature.

To assess optimism, the participants were asked to say whether they agreed fully, partially, or not at all with four statements: "I still expect much from life," "I do not look forward to what lies ahead for me in the years to come," "My days seem to be passing by slowly," and "I am still full of plans."

Optimistic men tended to exercise more and give higher ratings to their overall health, but that explained only a small part of the association, Dr. Erik J. Giltay, the study's lead author, told Reuters Health.

It's likely that optimism affects cardiovascular health in a number of ways, both directly and indirectly, according to Giltay, a researcher at the GGZ Delfland Institute of Mental Health in the Netherlands.

Men in the study completed the questionnaire gauging "dispositional optimism" at three different times during the 15-year follow-up. Overall, those men who were optimists in 1985, during the first test, were 55 percent less likely to die of heart disease or stroke by 2000. That was with other major factors -- like general health, smoking and family history of cardiovascular disease -- taken into account.

The link wasn't explained by optimists' lower rates of depression, a disorder that may raise the odds of cardiovascular disease.

So the "intriguing question," according to the researchers, is why optimism is associated with a lower risk of cardiovascular death.

One possibility, Giltay said, is that optimists are betting at coping with adversity, and may, for example, take better care of themselves when they do fall ill. Other studies, he said, have found that optimists seem to be better at coping with hardships such as illness or loss of a loved one.

On the other hand, the researchers note in the report, there may be a role for biological "consequences or predecessors" of pessimism. For instance, Giltay explained, certain genetic factors may underlie both heart health and a person's tendency to be optimistic or pessimistic.

In addition, a person's disposition may affect health through its influence on the nervous, immune and hormonal systems.

Personality traits tend to be stable over a lifetime, Giltay noted, so pessimism is likely to be a tough risk factor to change. So it's a good idea, he said, for older adults, especially those with a less-sunny disposition, to focus on heart risks they can alter, like smoking and inactivity.

SOURCE: Archives of Internal Medicine, February 27, 2006.