Pessimism Deadly for Heart Patients?
Outlook Affects Survival, Study Shows, So Look on the Bright Side
By
Salynn Boyles
WebMD Health News
Reviewed By
Louise Chang, MD
March 13, 2008 — Keeping a positive attitude is good for your health, and
if you are a heart patient it just may save your life, new research
suggests.
A study of patients with heart disease followed for six
to 10 years found that those with pessimistic beliefs about their recovery were
twice as likely to die during that timeframe as those who felt more
optimistic.
The research was presented this week in Baltimore at the annual meeting of
the American Psychosomatic Society, a group dedicated to the research of the
interaction between the mind and body.
"This study is one of the first to examine how a patient's attitude
toward their disease affects their health over the long term, and ultimately
their survival," says lead researcher John C. Barefoot, PhD.
Mind and Body Connection
Barefoot, Redford B. Williams, MD, and colleagues from Duke University
Medical Center conducted psychological assessments on 2,825 patients
hospitalized for heart disease.
The patients were asked to describe their expectations about their ability
to recover from their illness and regain a normal life.
During six to 10 years of follow-up, 978 of the patients died, with 66%
dying of heart disease.
Patient expectations about their disease course were highly related to
survival, with patients who had the most pessimistic views dying at twice the
rate of those who were most optimistic.
After controlling for factors that could influence survival, including
disease severity, functional status, and depression, the death rate among
the most pessimistic patients was still 30% higher than the most optimistic,
Williams tells WebMD.
"Negative outlook was an independent predictor of poor outcomes," he
says. "And there seems to be something protective about having a more
optimistic attitude that makes you feel that you are going to be OK."
He says patients with positive expectations may be more likely to make
lifestyle changes and follow treatment regimens prescribed by their
doctors.
The Impact of Stress
Another possible explanation is that positive thoughts may lessen the
damaging effects of stress on the body.
A separate study presented by the Duke researchers at the Baltimore meeting
examined this theory.
Researchers conducted personality profiles on 327 healthy people to
determine if they were more inclined to exhibit positive or negative emotions.
They then conducted tests designed to assess the study participants'
physiological responses to stress.
People identified as being more positive were found to have significantly
lower increases in blood pressure during stress
than people who were negative.
They also had lower levels of the stress hormone cortisol within 30 minutes
of waking — a time in which levels tend to be high.
"It's not just that negative emotions are harmful," lead researcher
Beverly H. Brummett, PhD, tells WebMD. "There seems to be something about
the experience of having more positive emotions. They seem to act as a buffer
against bad health outcomes."
Brummett says interventions like meditation, behavioral therapy, and regular exercise may help people with naturally gloomy dispositions
change their outlook.
But cardiologist Donald LaVan, MD, of the University of Pennsylvania, is not
so sure.
LaVan, who is a spokesman for the American Heart Association, tells WebMD
that very soon after the introduction of heart bypass surgery, cardiologists began to recognize that more optimistic
patients fared better in terms of recovery and even survival.
This recognition led to the advent of the Zipper Club, a volunteer group
made up of former heart surgery patients who help current patients deal with
the emotional aspects of their illness.
LaVan says studies like the ones presented at the Baltimore meeting help
advance the understanding of how emotions affect health.
"The conclusions are not too surprising, but the question becomes, 'Can
you do anything to change someone's attitude?'" he says. "Maybe you can
to some degree, but my clinical experience tells me that if a patient is walking around with a big black cloud over his head
there's not much you can do about it."
SOURCES: American Psychosomatic Society annual meeting, March 12, 2008,
Baltimore. John C. Barefoot, PhD, Duke University Medical Center, Durham, N.C. Redford B. Williams, MD, division head, Psychiatry and Behavioral Sciences,
Duke University Medical Center, Durham, N.C. Beverly H. Brummett, PhD, research professor, Duke University Medical
Center, Durham, N.C. Donald LaVan, MD, spokesman, American Heart Association; clinical associate
professor of medicine, University of Pennsylvania.
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