Optimists are twice as likely to be in ideal cardiovascular health

CHAMPAIGN, Ill. -- People who have upbeat outlooks on life have significantly better cardiovascular health, suggests a new study that examined associations between optimism and heart health in more than 5,100 adults.

"Individuals with the highest levels of optimism have twice the odds of being in ideal cardiovascular health compared to their more pessimistic counterparts," said lead author Rosalba Hernandez, a professor of social work at the University of Illinois. "This association remains significant, even after adjusting for socio-demographic characteristics and poor mental health."

Participants' cardiovascular health was assessed using seven metrics: blood pressure, body mass index, fasting plasma glucose and serum cholesterol levels, dietary intake, physical activity and tobacco use - the same metrics used by the American Heart Association to define heart health and being targeted by the AHA in its Life's Simple 7 public awareness campaign.

In accordance with AHA's heart-health criteria, the researchers allocated 0, 1 or 2 points - representing poor, intermediate and ideal scores, respectively - to participants on each of the seven health metrics, which were then summed to arrive at a total cardiovascular health score. Participants' total health scores ranged from 0 to 14, with a higher total score indicative of better health.

The participants, who ranged in age from 45-84, also completed surveys that assessed their mental health, levels of optimism, and physical health, based upon self-reported extant medical diagnoses of arthritis, liver and kidney disease.

Individuals' total health scores increased in tandem with their levels of optimism. People who were the most optimistic were 50 and 76 percent more likely to have total health scores in the intermediate or ideal ranges, respectively.

The association between optimism and cardiovascular health was even stronger when socio-demographic characteristics such as age, race and ethnicity, income and education status were factored in. People who were the most optimistic were twice as likely to have ideal cardiovascular health, and 55 percent more likely to have a total health score in the intermediate range, the researchers found.

Optimists had significantly better blood sugar and total cholesterol levels than their counterparts. They also were more physically active, had healthier body mass indexes and were less likely to smoke, according to a paper on the research that appears in the January/February 2015 issue of Health Behavior and Policy Review.

The findings may be of clinical significance, given that a 2013 study indicated that a one-point increase in an individual's total-health score on the LS7 was associated with an 8 percent reduction in their risk of stroke, Hernandez said.

"At the population level, even this moderate difference in cardiovascular health translates into a significant reduction in death rates," Hernandez said. "This evidence, which is hypothesized to occur through a biobehavioral mechanism, suggests that prevention strategies that target modification of psychological well-being - e.g., optimism - may be a potential avenue for AHA to reach its goal of improving Americans' cardiovascular health by 20 percent before 2020."

Believed to be the first study to examine the association of optimism and cardiovascular health in a large, ethnically and racially diverse population, the sample for the current study was 38 percent white, 28 percent African-American, 22 percent Hispanic/Latino and 12 percent Chinese.

Data for the study were derived from the Multi-Ethnic Study of Atherosclerosis, an ongoing examination of subclinical cardiovascular disease that includes 6,000 people from six U.S. regions, including Baltimore, Chicago, Forsyth County in North Carolina, and Los Angeles County.

Begun in July 2000, MESA followed participants for 11 years, collecting data every 18 months to two years. Hernandez, who is an affiliated investigator on MESA, is leading a team in conducting prospective analyses on the associations found between optimism and heart health.

"We now have available data to examine optimism at baseline and cardiovascular health a decade later," said Hernandez, who expects to have an abstract completed in 2015.

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Co-authors of the current study were Kiarri N. Kershaw of Northwestern University; Juned Siddique, Honghan Ning and Donald M. Lloyd-Jones, all of Northwestern University; Julia K. Boehm of Chapman University; Laura D. Kubzansky of Harvard University; and Ana Diez-Roux of Drexel University.

The National Heart, Lung and Blood Institute and the National Center for Research Resources funded the research.