Think positive for a healthy heart: Study

By Dr. Ananya Mandal, MDMar 1 2011

Researchers suggest that heart disease patients are more likely to survive if they have a positive outlook. The study was published Feb. 28 in the journal Archives of Internal Medicine.

For the study the team from Duke University Medical Center gave a psychological questionnaire to more than 2,800 heart disease patients and asked about their belief in their ability to recover from the illness and return to a regular routine. After 15 years, 1,637 of the patients had died. Of the deaths, 885 (54 percent) were due to heart disease. Patients who had an optimistic outlook were 30 percent less likely to die during the follow-up period, said the researchers. They found that the increased risk persisted even after compensation of a number of factors, including heart disease severity, age, gender, income, depression, and social support.

Lead author John. C. Barefoot said, “This study is unique because it shows that a patient’s attitude toward their disease not only impacts their ability to return to a normal lifestyle but also their health over the long term and ultimately their survival.” They speculate that optimists have been found to be more likely to address the demands of a problem rather than withdrawing or focusing on its emotional consequences. This coping predisposition may generalize to those patients with high recovery expectations, making their coping more effective in reducing risk factor levels and improving levels of life satisfaction. A second hypothesis is based on the likelihood that those with pessimistic expectations will experience more tension and negative emotions during the recovery period, resulting in heightened stress reactions, autonomic dysregulation and other physiological responses that increase the risk of cardiac events.

Barefoot said, for example, that there is some evidence that people with positive expectations have better exercise habits. “I think those kinds of things need to be investigated in much more detail,” he said. “The take-home message is that having positive expectations can not only make you feel better but also potentially live longer,” Barefoot added

Karol Watson, associate professor of cardiology at the David Geffen School of Medicine at UCLA and co-director of the UCLA Program in Preventative Cardiology, cited similar findings in other heart studies, and pointed out that the new study does not mean negative thinking causes heart patients to die sooner. Behavioral counseling might be useful for changing people’s outlook, but it has never proven to improve cardiovascular outcomes, Watson said. “It’s much harder to do than it sounds. One of the hardest things to do is to change adult behaviors,” she said.