Journal article
Optimism, cynical hostility, and incident coronary heart disease and mortality in the Women's Health Initiative
Circulation (New York, N.Y.), Vol.120(8), pp.656-662
08/25/2009
DOI: 10.1161/CIRCULATIONAHA.108.827642
PMCID: PMC2901870
PMID: 19667234
Abstract
Trait optimism (positive future expectations) and cynical, hostile attitudes toward others have not been studied together in relation to incident coronary heart disease (CHD) and mortality in postmenopausal women.
Participants were 97 253 women (89 259 white, 7994 black) from the Women's Health Initiative who were free of cancer and cardiovascular disease at study entry. Optimism was assessed by the Life Orientation Test-Revised and cynical hostility by the cynicism subscale of the Cook Medley Questionnaire. Cox proportional hazard models produced adjusted hazard ratios (AHRs) for incident CHD (myocardial infarction, angina, percutaneous coronary angioplasty, or coronary artery bypass surgery) and total mortality (CHD, cardiovascular disease, or cancer related) over approximately 8 years. Optimists (top versus bottom quartile ["pessimists"]) had lower age-adjusted rates (per 10 000) of CHD (43 versus 60) and total mortality (46 versus 63). The most cynical, hostile women (top versus bottom quartile) had higher rates of CHD (56 versus 44) and total mortality (63 versus 46). Optimists (versus pessimists) had a lower hazard of CHD (AHR 0.91, 95% CI 0.83 to 0.99), CHD-related mortality (AHR 0.70, 95% CI 0.55 to 0.90), cancer-related mortality (blacks only; AHR 0.56, 95% CI 0.35 to 0.88), and total mortality (AHR 0.86, 95% CI 0.79 to 0.93). Most (versus least) cynical, hostile women had a higher hazard of cancer-related mortality (AHR 1.23, 95% CI 1.09 to 1.40) and total mortality (AHR 1.16, 95% CI 1.07 to 1.27; this effect was pronounced in blacks). Effects of optimism and cynical hostility were independent.
Optimism and cynical hostility are independently associated with important health outcomes in black and white women. Future research should examine whether interventions designed to change attitudes would lead to altered risk.
Details
- Title: Subtitle
- Optimism, cynical hostility, and incident coronary heart disease and mortality in the Women's Health Initiative
- Creators
- Hilary A Tindle - University of Pittsburgh, PA, USA. tindleha@upmc.eduYue-Fang ChangLewis H KullerJoAnn E MansonJennifer G RobinsonMilagros C RosalGreg J SiegleKaren A Matthews
- Resource Type
- Journal article
- Publication Details
- Circulation (New York, N.Y.), Vol.120(8), pp.656-662
- Publisher
- United States
- DOI
- 10.1161/CIRCULATIONAHA.108.827642
- PMID
- 19667234
- PMCID
- PMC2901870
- ISSN
- 0009-7322
- eISSN
- 1524-4539
- Grant note
- KL2 RR024154 / NCRR NIH HHS R24 HL076852 / NHLBI NIH HHS HL076852 / NHLBI NIH HHS HL076858 / NHLBI NIH HHS L30 AT002496 / NCCIH NIH HHS L30 AT002496-03 / NCCIH NIH HHS K02 MH082998 / NIMH NIH HHS KL2 RR024154-03 / NCRR NIH HHS
- Language
- English
- Date published
- 08/25/2009
- Academic Unit
- Epidemiology; Internal Medicine
- Record Identifier
- 9983996083002771
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