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Optimistic Attitudes Protect Against Progression of Carotid Atherosclerosis in Healthy Middle-Aged Women

From the Departments of Psychiatry (K.A.M.), Epidemiology (K.S.-T.), and Psychology (L.H.K.), University of Pittsburgh, Pittsburgh, Pennsylvania; and the Department of Psychology (K.R.), Helsinki, Finland.

Address correspondence and reprint requests to Karen A. Matthews, PhD, University of Pittsburgh, 3811 O’Hara Street, Pittsburgh, PA 15213. E-mail: matthewska{at}upmc.edu

OBJECTIVE: Optimistic people report a higher quality of life, engage in more active coping and adopt more health-promoting behaviors than people low in optimism, ie, pessimism. We evaluated whether pessimists are more likely to show progression in carotid disease than optimists.

METHODS: A total of 209 middle-aged healthy premenopausal women enrolled in an epidemiological study of cardiovascular risk factors and had carotid scans 10.4 years and 13.5 years later when they were at least 5 years postmenopausal. Women completed the Life Orientation Test (LOT), a measure of pessimistic and optimistic attitudes, at study entry and at the time of the first carotid scan. Analyses evaluated the association of LOT scores and change in carotid intima medial thickness (IMT) across 3 years.

RESULTS: Multiple linear regression analyses showed that the higher the pessimism scores at study entry, the greater the increase in mean IMT (ß = 0.17, p < .007). A comparison of those in the lowest quartile of LOT scores (most optimistic) with those in the other three quartiles showed that the most optimistic group had less progression than the remaining more pessimistic women (mean percent increase = 1.3 and 6.0 for mean IMT, F = 15.4, p < .001). Women who were chronically optimistic at study entry and at the first carotid scan (bottom quartiles at both times) had less progression in mean IMT than did those who were chronically pessimistic (top quartiles at both times).

CONCLUSIONS: Optimistic women are less likely to show progression of carotid disease in mid-life than are pessimists.

Key Words: women, • optimism, • cardiovascular disease, • carotid disease, • psychosocial.

Abbreviations: LOT = Life Orientation Test;; IMT = intima medial thickness;; HWS = Healthy Women Study;; DBP = diastolic blood pressure;; SBP = systolic blood pressure;; HDL-C = high-density lipoprotein cholesterol;; BMI = body mass index;; HT = hormone therapy;; ANCOVA = analyses of covariance.

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