This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Google Scholar Articles by Roy, B. Articles by Cushman, M. PubMed PubMed Citation Articles by Roy, B. Articles by Cushman, M. Related Collections Immunology Personality Coronary Artery Disease

Association of Optimism and Pessimism With Inflammation and Hemostasis in the Multi-Ethnic Study of Atherosclerosis (MESA)

From the Center for Social Epidemiology and Population Health (B.R., A.V.D.-R., N.R.), University of Michigan, Ann Arbor, Michigan; Division of Geriatrics (T.S.), School of Medicine, UCLA, Los Angeles, California; Division of General Medicine (S.S.), College of Physicians and Surgeons, and Division of Epidemiology, School of Public Health, Columbia University New York, New York; and the Department of Medicine (M.C.), University of Vermont, Burlington, Vermont.

Address correspondence and reprint requests to: Ana V. Diez-Roux, Center for Social Epidemiology and Population Health, 109 Observatory, 3rd Floor Tower, Ann Arbor, MI 48109-2029. E-mail: adiezrou{at}umich.edu

Objective: To investigate the association between optimism/pessimism and concentrations of seven inflammation and hemostasis markers. Optimism and pessimism are associated with cardiovascular disease mortality and progression; however, the biological mechanism remains unclear.

Methods: This cross-sectional study used data from the Multi-Ethnic Study of Atherosclerosis (MESA), a study of 6814 persons aged 45 to 84 years with no history of clinical cardiovascular disease. The Life-Orientation Test-Revised (LOT-R) was used to measure dispositional optimism and pessimism. Regression analyses were used to estimate associations of optimism and pessimism with interleukin (IL)-6, C-reactive protein (CRP), fibrinogen, homocysteine, Factor VIII, D-dimer, and plasmin-antiplasmin, before and after adjustment for sociodemographics, depression, cynicism, health behaviors, body mass index (BMI), hypertension, and diabetes.

Results: Higher scores on the LOT-R (positive disposition) were related to lower concentrations of IL-6 (p = .001), fibrinogen (p < .001), and homocysteine (p = .031). Associations were stronger for the pessimism subscale. After adjustment for demographics, the percentage differences in inflammatory markers corresponding to a 2-standard deviation increase in pessimism were 6.01% (p = .001) for IL-6, 10.31% (p = .001) for CRP, 2.47% (p < .0001) for fibrinogen, and 1.36% (p = .07) for homocysteine. Associations were attenuated but significant after adjustment for sociodemographics, depression, cynical distrust, and behaviors. Further adjustment for hypertension, BMI, and diabetes reduced associations for CRP and IL-6. Pessimism remained associated with a 1.36% (p = .02) increase in fibrinogen in the fully adjusted model. Factor VIII, D-dimer, and plasmin-antiplasmin were not associated with the LOT-R or subscales.

Conclusions: Pessimism is related to higher levels of inflammation. Health behaviors, BMI, hypertension, and diabetes seem to play a mediating role.

Key Words: psychosocial factors • inflammation • coagulation • epidemiology • risk factors

Abbreviations: CVD = cardiovascular disease; CHD = coronary heart disease; MESA = Multi-Ethnic Study of Atherosclerosis; HTN = hypertension; BMI = body mass index; DM = diabetes mellitus; LOT-R = Life-Orientation Test-Revised; IL-6 = interleukin-6; CRP = C-reactive protein; CES-D = Center for Epidemiologic Studies Depression scale; HPA = hypothalamic-pituitary-adrenal; MI = myocardial infarction; SD = standard deviation.