Pessimism ups risk of death in heart patients

People with heart disease who have a pessimistic outlook are much more likely to die early compared to those who are more optimistic about their situation, researchers from Duke University Medical Center have found.

"This study is one of the first to examine how a patient's attitude toward their disease impacts their health over the long term - and ultimately their survival," Dr. John C. Barefoot, who presented the findings today at the American Psychosomatic Society Annual Meeting, said in a statement.

"The take-home message" for heart patients, he told Reuters Health, "is that having positive expectations can not only make you feel better but also potentially live longer." He also thinks doctors need to consider the role of their patient's beliefs as part of the recovery process.

The Duke team looked at individual expectations and death rates among 2825 adults who had heart disease detected between 1992 and 1996. In 2002, 6 to 10 years after being diagnosed with heart disease, 978 of the subjects had died - 66 percent from heart disease.

The investigators found that the most pessimistic heart patients - based on responses to a psychological questionnaire - were twice as likely to have died as the most optimistic heart patients.

The higher risk of death linked to pessimism remained consistent when the researchers accounted for factors that would also tend to increase the chance of dying, like the severity of heart disease, age, gender, income, signs of depression, and functional ability.

Studies are needed, the researchers say, to determine how a sunny outlook may affect disease survival. It's possible, they say, that coping behaviors, such as following a doctor's treatment plan, may contribute to an improved recovery, or that positive thoughts may lessen the damaging effects of stress on the body.

By Megan Rauscher

NEW YORK (Reuters Health)