Throughout history, optimism has been viewed as a cornerstone of resilience. In the words of Helen Keller, optimism is the faith that leads to achievement. Defined primarily as hopefulness for the future, optimism has also been heavily critiqued as having little value without action. Although this may be true in certain respects, a broad body of evidence suggests that pessimism can be associated with adverse health outcomes up to and including poor cardiovascular health. Given these observations, investigators have turned to evaluate the impact of optimism on disease prevention empirically. In September 2019, the results of a systematic review and meta-analysis were published in the Journal of the American Medical Association, examining how optimism can impact outcomes such as cardiovascular events. The findings of this investigation were eye-opening.
Through a systematic review of multiple research databases, investigators selected 15 studies that included over 200,000 participants. Primary outcome measures included severe conditions such as heart attack and stroke. With an average follow-up period of roughly 14 years, results indicated a significant relationship between optimism and reduced risk of adverse cardiac events. Perhaps of greater significance, results showed an association with reduced all-cause mortality as well.
In January 2021, a scientific statement from the American Heart Association revealed strong commentary on the subject. Following a rigorous evaluation of available evidence, several conclusions were summarized. Indeed, there is a strong association between mental health and cardiovascular disease risk. Interventions that improve mental health and wellbeing can have a measurable impact on cardiovascular health. Although multifactorial, it is well demonstrated that psychological health may impact heart health and vascular health either through direct or indirect mechanisms. Studies have also shown a potential protective benefit from other factors, including gratitude and happiness, as measured through positive affect.
Although the exact mechanism through which optimism and other positive psychological factors lead to the above observed phenomena is still unclear, good mental health is strongly associated with a reduction in cardiovascular disease risk. Indeed, it has also been known for some time that chronic stress can have multiple harmful health consequences. Therefore, it is prudent that a patient’s mental health be considered and addressed as part of any holistic cardiovascular disease management and risk mitigation strategy.