Abstract P538: Cardiovascular Health Benefits of Optimism are Socially Patterned: A 15-year Prospective Study

Abstract

Introduction: Optimism is consistently associated with better cardiovascular health but underlying mechanisms are poorly understood. This study examines prospective links between optimism and lipids in adulthood, and tests possible effect modification by social factors. Hypothesis: Greater optimism will predict healthier lipid profiles. Methods: Participants were 3,016 adults (mean age=40.2) recruited in 1985-6 from the Coronary Artery Risk Development in Young Adults Study. Optimism was measured in year 15 using the 6-item Life Orientation Test-Revised. Log-transformed triglyceride levels (TG) and total cholesterol to high-density lipoprotein cholesterol ratio (TC/HDL-C) were assessed from blood samples in years 15, 20, 25, and 30. Linear mixed models evaluated relationships between optimism and lipids controlling for relevant covariates. Stratified analyses tested associations by gender, race/ethnicity, and income. Results: On average, TG increased over time while TC/HDL-C decreased. Figure 1 shows unadjusted differences in mean lipid levels by optimism tertiles. In fully-adjusted models, higher optimism was associated with lower TG averaged over the follow-up (β=-0.028; 95% CI: -0.047, -0.010); a similar trend (though non-significant) was observed with TC/HDL-C (β=-0.024; 95% CI: -0.066, 0.018). In stratified analyses, optimism was more strongly associated with lower TG among women (vs. men), but no differences were noted by race/ethnicity or income. Associations with TC/HDL-C were stronger for women (vs. men) and white (vs. black) participants. Optimism was not related to increases in TG over time, but was associated with a slightly faster decline in TC/HDL-C (time interaction β=0.003; 95% CI: 0.001, 0.006). Declines in TC/HDL-C also varied by sex and race/ethnicity. Conclusion: Optimism contributes to lower lipid levels in adulthood, but associations vary by social status. The relationship between optimism and lipids may underlie previously noted associations with cardiovascular health.