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11-11-2009 | Stroke | Article

Pessimism shows “robust association” with stroke risk


Free abstract

MedWire News: Low levels of pessimism are robustly associated with a reduced risk for stroke, results of a large cohort study suggest.

The finding is in line with a growing body of evidence supporting a link between psychology and health outcomes, say the researchers, although the precise mechanisms underlying the association remain unclear.

Hermann Nabi (INSERM Unité 687, Vilejuif, France) and team investigated the association between stroke and dispositional optimism or pessimism, defined as a general tendency to exhibit positive or negative expectancies about the future.

Their data source was the Health and Social Support Prospective Cohort Study (HeeSSup), which is a random sample of 23,216 adults aged 20–54 years from Finland.

The subjects were assessed for psychological variables at baseline and followed-up for a mean of 7.0 years. During this time a total of 105 fatal and first nonfatal strokes occurred.

Dispositional pessimism was measured using the Life Orientation Test–Revised assessment, on which basis participants were divided into quartiles. In unadjusted analyses, participants in the lowest quartile (indicating a low level of pessimism) had a 56% lower risk for stroke (hazard ratio [HR]=0.44) compared with subjects in the highest quartile.

After adjusting for socioeconomic factors, cardiovascular risk factors, depression, general stress levels, and ischemic heart disease, the adjusted HR was 0.52 for the lowest versus the highest quartile of pessimism.

These data indicate the existence of a “robust association” between pessimism and stroke risk, and support a recent study which found lower survival from cancer among pessimistic versus less-pessimistic individuals.

Nabi and co-authors conclude: “Both behavioral (lifestyle behaviors) and biological (autonomic nervous system activity) mechanisms are plausible [underlying mechanisms]. Low pessimism may also be related to favorable trajectories of stroke risk factors over time.

“Further longitudinal studies are needed to examine these mechanisms in detail and whether interventions designed to reduce pessimism would alter stroke risk.”

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

By Joanna Lyford