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Optimism Can Benefit Heart Disease Patients

Positive outlook more likely to inspire positive lifestyle modifications.

A published study has found a link between positive psychological states and improved health and longevity in coronary heart disease (CHD) patients. The author evaluated 1,022 CHD patients at baseline and 662 CHD patients at 5-year follow-up. The subjects reported cigarette and alcohol use, medication adherence, physical activity, sleep quality, and positive affect.

High positive affect at baseline was correlated with improved health behaviors. Physical activity (OR = 1.52; 95% CI, 1.30-1.77, p < 0.001), sleep quality (OR = 1.24, 95% CI, 1.04-1.48, p = 0.015), nonsmoking (OR = 1.29, 95% CI, 1.06-1.57, p = 0.012), and medication adherence (OR = 1.46, 95% CI, .12-1.90, p = 0.005). The only measured health behavior that was not associated with high positive affect was alcohol use.

The author notes that a high positive affect at baseline did not have a predictive effect for health behavior at the 5-year follow-up. Despite this, increases in positive affect across 5 years were associated with improvements in physical activity (B = 0.023, SE = 0.008, p = 0.002), sleep quality (B = 0.011, SE = 0.005, p = 0.039), and medication adherence (B = 0.014, SE = 0.004, P < 0.001), but not cigarette or alcohol use.

These results may not be surprising for some. These improvements may be explained by the reaction that optimistic people will have to a difficult situation over pessimistic people. Congestive heart disease, which is a frightening diagnosis for many people, will involve a lot of work on the patient’s part to understand their disease state and motivate themselves to improve ingrained behaviors in order to live healthier. Optimism may enable patients to better cope and focus on improving the future instead of dwelling on the difficulty of the diagnosis.

The results of this research reinforce the idea that practitioners should approach counseling their heart disease patients in such a way that may enforce optimism for the situation. This can lead to improvements in their morbidity and mortality later on from lifestyle changes. Clinicians may want to screen their CHD patients for depression as well, since untreated depression can make optimism difficult to achieve.

Practice Pearls:

  • Positive affect in CHD patients at baseline was associated with improved health behaviors at baseline such as smoking cessation, increased physical activity, and medication adherence, but not alcohol use.
  • Positive affect at baseline was not associated with positive affect at follow-up, so positive thinking should be reinforced continually.
  • Improvements in positive affect over time were also associated with improvements in health behaviors over time.

Sin NL – Psychosom Med (2015) Positive Affect and Health Behaviors Across 5 Years in Patients With Coronary Heart Disease The Heart and Soul Study.pdf in Psychosomatic Medicine, Oct 18, 2015.