Optimistic people are likely to live longer after first heart attack (SQ-88)
“Optimism is the faith that leads to achievement. Nothing can be done without hope and confidence.”- Hellen Keller
How do you see your glass? Half-empty or half-full? It seems your heart health depends on it.
Studies show that optimistic people tend be healthier and even have a longer life span than people with a not so sunny outlook on life. Being optimistic is good for both emotional and physical health. But can it help you live longer after you have had a heart attack? Is it good for your heart health?
Life expectancy after an episode of heart attack depends on many factors. For example, was it a minor or major attack? How quickly was treatment started? Factors like age, sex and lifestyle also play a huge role in how a heart attack would affect a person’s life span. But how is optimism related to improved longevity after such an event?
Optimism is all about having positive expectations from life. Many studies have demonstrated that an optimistic disposition towards life can work wonders for your heart health. We will talk about these studies later in this blog but let’s first look at this 2016 study that says optimistic approach is what is required to live a long life after a heart attack.
Of course, you can’t and shouldn’t underestimate the role of medical care and lifestyle and dietary modifications in managing your life after a heart attack. But it does seem that optimism plays some role too, if you go by this research published in the journal Mayo Clinic Proceedings. Research led by Dr. Yariv Gerber of Israel's Tel Aviv University found that:
- People with a positive outlook towards life are more likely to live longer after their first heart attack than people with a pessimistic attitude.
- There are more chances that optimistic people were educated, employed and have strong social support. These individuals were also less likely to smoke or have depressive symptoms.
The study concluded, “Higher levels of optimism during hospitalization for MI (Myocardial Infarction) were associated with reduced mortality over a 2-decade follow-up period. Optimism training and positive psychology should be examined as part of psychosocial interventions and rehabilitation after MI.” 
The link between emotional wellbeing and physical health is neither new nor surprising. In fact, there is mounting evidence that suggests a positive association between being optimistic and better heart health. A sunny outlook on life can improve your cardiovascular health, according to a latest 2018 study published in the BMJ Open.
The researchers made use of the American Heart Association’s “Life’s Simple 7” assessment to evaluate the cardiovascular health (heart score) of the study participants. These seven parameters include blood pressure, cholesterol, blood sugar, physical activity, diet, weight and smoking. The researchers also measured participants’ optimism levels using the Life Orientation Test-Revised (LOT-R). This assessment includes a series of questions that describes a person’s general outlook on life.
The results of the study demonstrated a strong relationship between higher optimism and improved cardiovascular health. The study “offers preliminary evidence for an association between optimism and CVH in a large heterogeneous group of Hispanic/Latino adults. Our study adds scientific knowledge of psychological assets that may promote CVH and suggests a novel therapeutic target for consideration.” 
Being an observational study, it doesn’t prove a cause-and-effect relationship but the strong co-relation is backed by previous studies that also show that a bright outlook towards life is an important tool in improving your heart as well as overall health.
According to Rosalba Hernandez, the chief researcher of the study, "Each unit increase in an adult's level of optimism was associated with 3 percent higher odds of meeting the criteria for ideal cardiovascular health across four or more metrics. The correlation between optimism and cardiovascular health was consistent across heritage groups, regardless of age, sex, or level of acculturation." 
Many studies show that optimism is associated with:
- Healthy lipid profiles (greater HDL cholesterol and lower triglycerides levels) 
- Reduced risk of death from coronary heart disease 
- Faster recovery from cardiac surgery
- Reduced risk of cardiovascular disease 
- Lower levels of stress induced inflammation  
- Lower levels of inflammation and better endothelial function in healthy older men without coronary heart disease. Endothelial function is a strong determinant of heart health. 
The study, by researchers from the University College London, investigated the effects of optimism on physical and emotional health in 369 people who were recovering from a heart attack or unstable angina. The study monitored the likelihood of having a major heart event, such as a heart attack and stroke, in the next 46 months.
The study found that people with a more optimistic approach and less depressive symptoms had half the risk of having a major cardiac event or dying from heart related problem. More optimistic people also shared some other traits; for example, these individuals were less likely to smoke and there were more chances of them eating recommended portions of fruits and vegetables. They were also physically healthier.
The study concluded “Optimism predicts better physical and emotional health after ACS. Measuring optimism may help identify individuals at risk. Pessimistic outlooks can be modified, potentially leading to improved recovery after major cardiac events.”  The results hinted that optimistic people are more open to making changes that contribute to better health such as stopping smoking and eating healthy.
Optimistic people are also likely to recover better from an event like coronary artery bypass surgery than pessimists. In fact, studies show that people with positive expectations from life and who are hopeful about their future tend to live longer after they have been diagnosed with diseases like cancer and HIV/AIDS. They also have better quality of life than people who with a less hopeful disposition.
Optimism and reduced risk of hypertension
This article from Harvard Health Publishing refers to a study from Finland which shows that having a cheerful, positive outlook also reduces the risk of developing high blood pressure, one of the major risk factors for cardiovascular disease. It found that men with high levels of pessimism were three times more likely to develop blood pressure than people who tend to be optimistic about life. The risk existed even after the researchers considered other important cardiovascular risk factors such as smoking, obesity, sedentary lifestyle, excessive drinking, and a family history of high blood pressure.
So, what is it about being optimistic that may help your heart health?
How optimism may help?
Experts believe that being positive about life may make people open to making positive changes in their lives and improving their health. Whether it is being more physically active, eating healthy or quitting a bad habit like smoking, people who tend to see their glass as ‘half-full’ are more likely to embrace changes that can help them achieve better health outcomes.
Optimism is not simply about ignoring or underestimating bad consequences. It is not about being naïve. Rather, it is about accepting there are risks and there are chances of things going downhill, and devising plans and strategies that may help deal with these risks in a concrete fashion.
How do you think optimism may help to improve your heart health? Are there any mechanisms involved? While the underlying mechanisms are not entirely clear, it is believed that having a sunny outlook may work in various ways to help you achieve better health.
People with a more hopeful attitude:
- Tend to seek a healthier lifestyle and are more likely to opt for dietary and lifestyle modifications required to support and maintain their heart health. They are also more likely to follow medical advice.
- Understand risks better and create plans to achieve their health goals
- May have lower levels of stress, anxiety and depression. All these factors promote inflammation and poor immune functions
- Have reduced levels of inflammation. Chronic, systemic inflammation is one huge risk factor when it comes to heart health. It is one of the key steps involved in the onset and progression of atherosclerosis – plaque build-up in the arteries – that increases your risk of heart attack and stroke. Studies have found that optimistic people have lower levels of inflammatory markers like C-reactive protein (CRP) and interleukin-6, which markers are used to predict underlying inflammation and risk of heart attack or stroke.
- Are likely to have better social relationships and support systems
- Are less likely to smoke or go on a drinking binge
What else can you do to improve your heart health?
Along with the medications, making changes to your lifestyle and diet is also important to make sure your heart gets all the additional help it needs. And as we just found out, being optimistic about life challenges and hoping for positive outcomes also work in the favour of your heart.
However, there is another aspect that most conventional cardiologists tend to overlook: nutritional support!
Certain nutrients are extremely beneficial to your heart health. Whether helping your heart muscle to make enough energy or providing antioxidant support to reduce oxidative damage and inflammation, these nutrients play a very important role in maintaining your overall cardiovascular health.
There is a lot of scientific data showing that nutrients such as CoQ10, magnesium, vitamin D3 and vitamin K2 play a remarkably helpful role in protecting your heart from oxidative stress and inflammation. In addition, these heart-protective vitamins, minerals and co-enzymes also have positive effects on risk factors that damage your cardiovascular health, such as insulin resistance, diabetes, high blood pressure and poor endothelial functions. Moreover, their deficiency in the body increases your risk of heart disease and associated risk factors.
Lowering inflammation through their anti-oxidant and anti-inflammatory properties is one of the most important mechanisms through which CoQ10, magnesium and vitamin D may boost your heart health. While acute, short-term inflammation is important to fight infections and heal injuries, long-term inflammation is detrimental to your heart health and overall well-being.
As mentioned previously in this article, persistent inflammation in the body (due to a long-standing infection, chronic stress and exposure to environmental toxins; with all these factors leading to increased oxidative damage and inflammation), is one of the main steps in the development of heart disease, not to mention other health conditions that stem out of inflammation such as cancer, cataracts, macular degeneration, type 2 diabetes, arthritis, auto-immune disorders, Alzheimer’s and Parkinson’s.
In addition to their powerful anti-oxidant and anti-inflammatory properties, these nutrients (CoQ10, magnesium, vitamin D3 and vitamin K2) work through several other mechanisms that also have heart-healthy benefits. For example, CoQ10 plays an integral role in the bio-chemical reactions that produce energy in the body. Since your heart requires a lot of energy to function, CoQ10 is one of the best supplements you can take to improve your heart function. It is especially beneficial in improving the symptoms of heart failure and reducing the risk of more heart attacks. It also protects the heart during and after cardiac surgery due to its antioxidant properties.
Magnesium, vitamin D3 and vitamin K2 help in reducing blood pressure and improving insulin sensitivity, risk factors for heart disease. In addition, magnesium is very effective in reducing your stress levels. Deficiency in magnesium and vitamin K2 is known to promote excessive calcification in the arteries (build-up of calcium). Both these nutrients reduce the risk of arterial calcification that can cause coronary heart disease and peripheral arterial disease.
There is a lot that goes into keeping your heart in good shape. From consuming a healthy diet of fresh foods to being physically active and taking antioxidant supplements, you can do a lot to support your heart health. At the same time, don’t forget that a positive outlook on life, rather than expecting the worst, gives your body an additional tool to keep you healthy. It may even help you survive longer after the first incident of heart attack and help you bounce back from surgeries and other major cardiac events faster.
- Weiss-Faratci, Netanela et al. Optimism During Hospitalization for First Acute Myocardial Infarction and Long-Term Mortality Risk. Mayo Clinic Proceedings. 2016.
- Hernandez et al. Association of dispositional optimism with Life’s Simple 7’s Cardiovascular Health Index: results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study (SCAS). BMJ. 2018.
- David DiSalvo. Optimistic Thinking Gives Heart Health A Boost, Study Finds. 2018.
- Boehm JK et al. Relation between optimism and lipids in midlife. Am J Cardiol 2013
- Anthony et al. Optimism and mortality in older men and women: The rancho bernardo study. J Aging Res 2016
- Boehm JK et al. The heart’s content: the association between positive psychological well-being and cardiovascular health. Psychol Bull 2012
- Brydon Let al. Dispositional optimism and stress-induced changes in immunity and negative mood. Brain Behav Immun 2009.
- Roy et al. Association of optimism and pessimism with inflammation and hemostasis in the Multi-Ethnic Study of Atherosclerosis (MESA). Psychosom Med 2010.
- keda et al. Optimism in relation to inflammation and endothelial dysfunction in older men: the VA Normative Aging Study. Psychosom Med 2011.
- Ronaldson et al. Optimism and Recovery After Acute Coronary Syndrome: A Clinical Cohort Study. Psychosomatic Medicine. 2015.