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Optimism May Help Heart Health

I'm wary of the notion that a positive mental attitude can help people survive medical crises, mostly because I've known some incredibly upbeat people who have died of cancer. A good outlook and cheerful demeanor can't hurt, I suppose, but the pressure on sick people to maintain those attitudes seems kind of unrealistic, and the suggestion that by failing to be cheerful they contribute to their own demise seems unfair.

But a study in the July/August issue of the Annals of Family Medicine makes a credible case for optimism as a tool against cardiovascular disease - at least as far as men are concerned.

Robert Gramling of the University of Rochester Medical Center tracked nearly 3,000 adults ages 35 to 75 with no prior history of heart disease over 15 years, collecting baseline data from 1990 to 1992 and checking their health outcomes through 2005.

Gramling found that the men who at the outset reported thinking that they were at less risk than other guys their age of dying of a heart attack or stroke within the next five years were in fact far less likely to die from a heart attack or stroke than those who thought they were at higher risk. The optimists had a three-times lower incidence of death from these cardiovascular events than the less-optimistic chaps.

This, despite that fact that about half the fellows who thought so well of their heart health -- whether that was an accurate assessment, an expression of naivete, or a form of denial -- would have been categorized as being at high or very high risk of heart trouble if evaluated via objective medical tests.

Gramling reasons that some degree of concern over one's health can lead people to take steps to protect their health - like getting a vaccination, for instance. But faced with the kind of long-term work it takes to maintain heart health, such as exercising and eating right, some folks might get discouraged or fearful and do counterproductive things, like overeating comfort foods or drinking too much alcohol, to allay that discomfort. In turn, he figures, those who aren't too worried about their hearts might be less likely to indulge in those destructive behaviors.

Unfortunately, the data didn't paint a similar picture for women; those who felt they were at low risk fared no better than those who thought their risk was greater. Gramling thinks this may have to do with the fact that, when the study started, little was understood about women's heart-disease risk. As the study notes, perceptions of women's risk of cardiovascular disease were so low back then that even those women who said they were at equal or higher risk than other women weren't exactly expressing pessimism. Now of course we know that heart disease is at least as big a threat to women as it is to men and is the leading cause of death among women, far surpassing cancer as a killer.

Gramling's not ready to prescribe a dose of optimism to ward off heart attacks, though. "Our study can't tell you what changing your behavior can or can't do," he says. He's looking instead to the medical community to rethink the way it talks to patients about cardiovascular risk. "Some of the labels are pretty negative," he says. "Instead of talking about 'high risk,'" and thus invoking fear, he suggests, "maybe we should change the language so we're not trying to overtly shape [patient] perception."

By Jennifer LaRue Huget  |  July 16, 2008; 7:00 AM ET
Categories:  General Health  
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