A Positive Outlook Will Keep Your Heart Healthy


Heart disease is the most common ailment among American men and women, and while most of us know that we must improve certain risk factors, such as diet, exercise and cigarette smoking, there is another behavior we can emulate for positive heart health: optimism.

Positive Expectations Can Improve Coping, Reduce Stress

Professor emeritus John Barefoot PhD at Duke University Medical Center and colleagues followed 2,818 heart patients for approximately 15 years. All patients had had a coronary angiography to evaluate blood flow through the arteries of the heart. The patients completed an 18-item questionnaire about their future after the cardiac procedure.

The researchers measured their expectations on their ability to recover and return to normal physical activities. The patients were asked to agree or disagree with such statements as “I can still live a long, healthy life” or “I doubt that I’ll ever fully recover.”

Even after accounting for factors such as disease severity, health history, depressive symptoms, social support, age, sex, education and income, those with a more optimistic outlook on their future had a 30% greater chance of survival than those who were more pessimistic. The patients also had improved physical functioning after just one year.

Read: Optimism Lowers Heart Disease Risk in Men and Women

The researchers noted that the level of optimism didn’t have to be extreme to have an effect. Even moderately optimistic patients – those who scored in the 75th percentile – were more likely to have positive outcomes than those who scored in the lowest percentile.


"Our research shows better physical recovery and a higher likelihood of survival is linked to attitude — personal beliefs about their illness," Barefoot says.

Dr. Barefoot suggests two possible reasons for the link between a positive outlook and improved heart health. First, patients with positive expectations are more likely to follow their treatment plans and are better at coping with their illness. They are more likely to find solutions to problems versus just giving up. This includes overcoming barriers to exercise, for example.

Read: Expect the Best and Boost Your Immune System

Second, patients with positive expectations have less of a stress reaction. Unmanaged stress is linked to heart problems such as high blood pressure, chest pains, and irregular heartbeats. High levels of stress may also worsen cholesterol and increase exposure to elevated levels of hormones such as adrenaline and cortisol. Stressed patients are also more likely to smoke, overeat, and exercise less.

In an accompanying editorial, Drs. Robert Gramling and Ronald Epstein, both of the University of Rochester in New York, call optimism a “powerful drug that compares favorably with highly effective medical therapies.” They suggest more research to “unveil the pathways underlying this phenomenon.”

Dr. Barefoot says his next step is to determine whether simple interventions aimed at boosting optimism, such as brief counseling during hospitalization, can make a meaningful difference in long-term health and longevity.

The findings of Dr. Barefoot’s study and Drs Gramling and Epstein’s editorial are published in the February 28th issue of Archives of Internal Medicine.