Dr Martin Juneau, M.D., FRCP

Cardiologue, directeur de l'Observatoire de la prévention de l'Institut de Cardiologie de Montréal. Professeur titulaire de clinique, Faculté de médecine de l'Université de Montréal. / Cardiologist and Director of Prevention Watch, Montreal Heart Institute. Clinical Professor, Faculty of Medicine, University of Montreal.

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10 February 2020
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Optimism reduces the risk of cardiovascular disease and mortality


  • According to a meta-analysis of 15 studies, optimism was associated with a 35% lower risk of cardiovascular events and a 14% lower risk of mortality.
  • Another study published in 2019 suggests that optimism is associated with exceptional longevity (≥85 years) in two separate cohorts of men and women.

It is now well established that there is an association between negative emotions (anger, trauma), sociocultural factors, chronic stress and the development of heart problems. Much less is known about the potential impact of mental attitude on cardiovascular risk, but there has been more and more research on this topic in recent years.

Optimism is a mental disposition characterized by the general idea that good things will happen, or by the sense that thefuture will be favourable to us, since we can, if necessary, manage important problems. In empirical studies, optimism has been associated with greater success in school, work, sports, politics and interpersonal relationships. Studies have reported that optimistic people are less likely to suffer from chronic diseases and die prematurely than pessimistic people. For example, in a large prospective study, published in a prestigious scientific journal and involving more than 6,000 people, the most optimistic participants were 48% less likely to have heart failure than the least optimistic. Positive mental attitudes other than optimism, such as kindness, gratitude, and indulgence, and psychosocial factors other than pessimism, such as depression, anxiety, chronic stress, social isolation, and low self-esteem, can also have an effect on the risk of developing a chronic disease.

Optimism and cardiovascular disease
A meta-analysis of 15 studies published in 2019, including 229,391 participants, examined the association between optimism and cardiovascular events or all-cause mortality. After an average follow-up of 13.8 years, optimism was associated with a 35% lower risk of cardiovascular events and a 14% lower risk of mortality. In 12 of the 15 studies included in this meta-analysis, there was a linear relationship between the participants’ level of optimism and the decrease in the risk of cardiovascular events.

Optimism and longevity
Another study published in 2019 suggests that optimism is associated with exceptional longevity (≥85 years) in two separate cohorts of men and women. The data analyzed came from the Veterans Affairs Normative Aging Study (NAS) and the Nurses’ Health Study (NHS), with a follow-up after 30 years and 10 years, respectively. The most optimistic women in this study (top quintile) had an average lifespan 14.9% longer than the least optimistic women (bottom quintile). Similar results were obtained for men: the most optimistic had a lifespan 10.9% longer on average. The most optimistic participants were 1.5 times (women) and 1.7 times (men) more likely to live to age 85 than the least optimistic participants. These associations are independent of socio-economic status, health status, depression, social integration and health behaviours (e.g., smoking, diet, alcohol consumption).

In an editorial accompanying the publication of this study, Dr. Jeff C. Huffman concludes by answering the following question: Where does the field go from here?

“In terms of longitudinal studies, conducting studies that continue to examine the associations of more modifiable or state-based constructs with health outcomes will help to define clear, plausible, and important targets for intervention. These studies could also include more novel methods for assessing well-being, including ecological momentary assessment (Editor’s note: a method for assessing fluctuating and environmentally dependent psychological states) or Day reconstruction methods (Editor’s note: a method that assesses how people spend their time and how they experience the various activities and settings of their lives) that address the challenges with single or retrospective sampling.”

“Regarding intervention studies, interventions should focus on improving and measuring not only well-being, but also important additional downstream outcomes (e.g., physical activity and biomarkers) that are associated with health. Ongoing studies should also determine whether programs to promote psychological well-being might be best used alone or in conjunction with other, established behavioural interventions to boost their effect.”

Because a person’s level of optimism can be modified, these data suggest that optimism could be an important psychosocial resource for interventions to prevent or delay heart disease and prolong the lives of the elderly.

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