Association of Optimism With Cardiovascular Events and All-Cause Mortality: A Systematic Review and Meta-analysis.

Rozanski A, Bavishi C, Kubzansky LD, Cohen R

JAMA network open · September 4, 2019

Importance: Optimism and pessimism can be easily measured and are potentially modifiable mindsets that may be associated with cardiovascular risk and all-cause mortality. Objective: To conduct a meta-analysis and systematic review of the association between optimism and risk for future cardiovascular events and all-cause mortality. Data Sources And Study Selection: PubMed, Scopus, and PsycINFO electronic databases were systematically searched from inception through July 2, 2019, to identify all cohort studies investigating the association between optimism and pessimism and cardiovascular events and/or all-cause mortality. Results: The search yielded 15 studies comprising 229,391 participants of which 10 studies reported data on cardiovascular events and 9 studies reported data on all-cause mortality. The mean follow-up period was 13.8 years. On pooled analysis, optimism was significantly associated with a decreased risk of cardiovascular events (relative risk, 0.65; 95% CI, 0.51-0.78; P < .001). Similarly, optimism was significantly associated with a lower risk of all-cause mortality (relative risk, 0.86; 95% CI, 0.80-0.92; P < .001). Subgroup analyses by methods for assessment, follow-up duration, sex, and adjustment for depression and other potential confounders yielded similar results. Conclusions And Relevance: The findings suggest that optimism is associated with a lower risk of cardiovascular events and all-cause mortality.

PMID: 31560385 · DOI: 10.1001/jamanetworkopen.2019.12200