Attitude Adjustment: Optimism Can Stave Off Stroke in Older Patients

July 22, 2011— -- Looking on the brighter side of life just may save your life, according to new research from the University of Michigan. In a study of 6,000 adults over 50 with no history of stroke, optimism was associated with significantly reduced risk of stroke, even when controlling for stroke risk factors such as high blood pressure, heart disease, hypertension and body mass index.

"Past research has linked optimism with a range of health benefits, including cardiovascular outcome," says lead author Eric Kim, a doctoral student in clinical psychology at the University of Michigan. The study was published Thursday in the journal Stroke.

Kim and colleagues drew on data from the National Institutes of Health Health and Retirement Study, analyzing the relationship between how participants scored on an 15-point optimism scale and how likely they were to suffer a stroke during a two-year follow-up period. Optimism was gauged by how stronlgy patients agreed with statements like: ""In uncertain times, I usually expect the best." They found that for each point increase in optimism rating, patients were 9 percent less likely to suffer a stroke. The reduction in risk is on par with the reduction seen in those making dietary changes, such as increasing fruits and vegetables in the diet.

Previous studies have linked antagonistic and disagreeable personalities with increased risk of heart attack and stroke, and a lack of pessimism with better heart outcomes and optimism in decreased mortality in those who have had heart attacks.

Given the mounting evidence that ties an optimistic attitude to a better outcome, these results hardly came as a surprise to researchers. What remains a mystery is exactly how a sunny attitude affects heart health.

Optimism could be working by reducing blood pressure, or the extent to which blood pressure spikes when stressed out, or it could be that those who are optimistic are more likely to engage in healthy behaviors such as good eating and exercise, says Dr. Redford Williams, a professor of psychology and neuroscience at Duke University who has studied the connection between personality traits and health extensively.

"We can't say for sure which thing is responsible for reduction in stroke, or as we have found in a recent study, a reduction in mortality among those with heart disease. It's pretty clear though, that something in optimism and related psychological characteristics is protective," he says.

Optimism Makes for Health, or Good Health Makes You Optimistic?

What's difficult to parse in all this optimism research is how optimism directly acts on either biological functions or health behavior. Because research hasn't yet confirmed a direct cause and effect with, say, an "optimism intervention" program, some doctors question whether these studies are perhaps capturing some other variable that goes along with optimism, such as adhering to medical advice.

Kim notes that previous research found that those who are higher in optimism are more likely to take vitamins and are more likely to adhere to a health program in cardiac rehab following a heart attack or stroke.