Optimism may serve as a psychological resource that promotes healthy behaviors and, ultimately, cardiovascular health. 3, 11 – 13 Most people desire to lead healthy lives, but the behaviors that provide the foundation for a healthy life can be difficult to achieve. Associations are also maintained after statistically controlling for sociodemographic characteristics, known cardiovascular risk factors, and psychological distress (eg, symptoms of depression and anxiety), all of which may confound the relationship.īesides optimism’s potential direct effects on physiological processes, as well as its possible role buffering against the harmful consequences of stress, theorists posit that individuals with greater optimism enjoy better health outcomes because they engage in healthier behaviors such as exercising, eating fruits and vegetables, and avoiding cigarette smoking. 10 Notably, associations between optimism and reduced risk of cardiovascular disease are evident in varied populations, including younger and older men and women from different countries. 9 In another study of nearly 100 000 US women, findings were similar with the most optimistic women demonstrating 30% reduced risk of death because of coronary heart disease relative to the least optimistic. 4 – 8 For example, in 1 study of British men and women, those who were more optimistic at baseline were 27% less likely to develop coronary heart disease over ≈5 years of follow-up compared with those who were less optimistic. In prospective longitudinal studies with epidemiological cohorts and clinically assessed outcomes, optimism consistently predicts reduced risk of cardiovascular disease and cardiovascular-related mortality. 2, 3 To date, the most rigorous evidence of optimism’s association with better health comes from the cardiovascular domain. Optimistic individuals generally enjoy healthier and longer lives than their less optimistic peers. 1 These generalized expectations about what the future will bring have important consequences for health. Optimistic people tend to expect that they will encounter favorable outcomes, whereas less optimistic people tend to expect that they will encounter unfavorable outcomes.
Additional longitudinal and experimental research is required to determine whether optimism causally contributes to healthy behaviors and whether optimism could be an effective target for preventing cardiovascular disease. Optimism is associated with healthier behaviors that protect against cardiovascular disease, although most evidence was relatively low quality. Most evidence was cross-sectional (≥53% of effect sizes) and did not consider sociodemographic characteristics (<53% of effect sizes) or psychological distress (<27% of effect sizes) as potential confounders. Findings suggested that more optimistic individuals tended to engage in healthier behaviors compared with less optimistic individuals, but effect sizes were modest ( r activity=0.07, P<0.0001 r diet=0.12, P<0.0001 and r smoking=0.07, P=0.001). We identified 34 effect sizes for physical activity (n=90 845), 15 effect sizes for diet (n=47 931), and 15 effect sizes for cigarette smoking (n=15 052). PubMed and PsycINFO databases were searched for studies published through November 2017 reporting on optimism’s relationship with physical activity, diet, and cigarette smoking. We conducted random effects meta-analyses examining optimism’s association with 3 health behaviors relevant for the prevention of cardiovascular disease. Moreover, it is unclear whether optimism temporally precedes health behaviors or whether the relationship is because of shared common causes. However, researchers have not formally determined the extent or direction of optimism’s association with health behaviors. One explanation for this is that optimistic people may be more likely to engage in healthy behavior like exercising frequently, eating fruits and vegetables, and avoiding cigarette smoking. Optimistic people have reduced risk for cardiovascular disease and cardiovascular-related mortality compared with their less optimistic peers. Customer Service and Ordering Information.Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).
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