Abstract
BackgroundMortality from coronary heart disease (CHD) remains at quite notable levels. Research on the risk factors and the treatment of CHD has focused on physiological factors, but there is an increasing amount of evidence connecting mental health and personality traits to CHD, too. The data concerning the connection of CHD and dispositional optimism and pessimism as personality traits is relatively scarce. The aim of this study was to investigate the connection between optimism, pessimism, and CHD mortality.MethodsThis was an 11-year prospective cohort study on a regional sample of three cohorts, aged 52–56, 62–66, and 72–76 years at baseline (N = 2815). The levels of dispositional optimism and pessimism of the study subjects were determined at baseline using a revised version of the Life Orientation Test (LOT-R). Eleven years later, those results and follow-up data about CHD as a cause of death were used to calculate odds. Adjustments were made for cardiovascular disease risk.ResultsThose who died because of CHD were significantly more pessimistic at baseline than the others. This finding applies to both men and women. Among the study subjects in the highest quartile of pessimism, the adjusted risk of death caused by CHD was approximately 2.2-fold (OR 2.17, 95 % CI 1.21–3.89) compared to the subjects in the lowest quartile. Optimism did not seem to have any connection with the risk of CHD-induced mortality.ConclusionsPessimism seems to be a substantial risk factor for death from CHD. As an easily measured variable, it might be a very useful tool together with the other known risk factors to determine the risk of CHD-induced mortality.
Highlights
Mortality from coronary heart disease (CHD) remains at quite notable levels
We found that in this age-specified general population sample, Life Orientation Test (LOT)-R is a scale with two independent subscales [32], and the use of the bipolar model would have hidden some of results found in our study
There were no differences between men and women in optimism (LOT-R subscale score mean (SD): 8.34 (2.10) vs 8.40 (2.08), Mann–Whitney U test p = 0.70) or in pessimism (3.85 (2.67) vs 3.80 (2.61), p = 0.83, respectively)
Summary
Mortality from coronary heart disease (CHD) remains at quite notable levels. Research on the risk factors and the treatment of CHD has focused on physiological factors, but there is an increasing amount of evidence connecting mental health and personality traits to CHD, too. Coronary heart disease (CHD) is still the leading cause of mortality, despite growing knowledge of its risk factors and the new treatments available [1]. According to the latest statistics, CHD causes about 200 deaths per 100,000 annually in industrialized countries (e.g. in 2013 193.3/100,000 in the United States and 193.6/100,000 in Finland) [2, 3]. The majority of those with CHD have at least one of the four most important physiological risk factors (diabetes, hypertension, smoking, or elevated lipids) [4]. In the INTERHEART study, psychosocial factors such as depression and psychosocial stress were found to be one of the most significant risk factors for myocardial infarction [6, 7], and the American Heart Association has stated that depression is an independent risk factor for a poor prognosis following an acute coronary syndrome [8]
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