Pessimism, Cynicism Can Hurt Your Heart

Study: Negative Outlook Appears to Raise Risk of Heart Disease, Death

Medically Reviewed by Elizabeth Klodas, MD, FACC on August 10, 2009
From the WebMD Archives

Aug. 10, 2009 -- Whether you believe the metaphorical glass is half full or half empty may not only affect how you see the world, it may also affect your heart.

New research suggests that having a positive attitude just might protect against heart disease and keep you alive.

The study of postmenopausal women is one of the largest ever to examine the impact of personality and temperament on the heart.

Just as optimism appeared to protect against heart disease and death, pessimism seemed to increase the risk for both.

And women with the highest degree of hostility and cynicism were also more likely to die than those with the sunniest dispositions.

“We don’t know exactly why, but attitude does appear to matter when it comes to heart disease and health,” University of Pittsburgh Medical Center internist Hilary A. Tindle, MD, MPH tells WebMD.

Pessimism, Hostility Bad for the Heart

The study participants were enrolled in the Women’s Health Initiative, a 15-year study that included about 162,000 postmenopausal women. None of the women had heart disease when they entered the study.

About 97,000 were included in the analysis by Tindle and colleagues.

The women completed surveys at study entry designed to assess their degree of optimism and their general level of hostility and cynicism.

For the optimism survey, the women were asked to answer "yes" or "no" to questions like, "In unclear times, I usually expect the best,” and “If something can go wrong for me, it will.”

The cynicism/hostility "yes" or "no" survey included questions like, “I have often had to take orders from someone who did not know as much as I did,” and “It is safer to trust nobody.”

Over eight years of follow-up:

  • Women who scored highest for optimism had a 9% lower risk for developing heart disease and a 14% lower risk of dying from all causes than women who scored lowest for optimism.
  • Women with a high degree of hostility and cynicism were 16% more likely to die than women who scored lowest for hostility and cynicism. The heart disease rate was similar for both groups.

Optimistic African-American women had a 33% lower risk for death than African-American women who were pessimists. Among white women, the survival advantage for optimists was 13%. African-American women who scored highest for hostility and cynicism were 62% more likely to die than African-American women who scored lowest.

Can a Pessimist Become an Optimist?

Compared to pessimists, optimists were more likely to be younger, live in the western U.S., have higher education and income levels, have a job, have health insurance, and attend church.

Pessimists were more likely than optimists to have diabetes, high blood pressure, high cholesterol, and suffer from depression. They were also more likely to be overweight, smoke, and avoid exercise.

But these factors did not fully explain the difference in heart disease and death risk between the two groups, Tindle says.

The study will appear in the Aug. 25 issue of the American Heart Association journal Circulation.

Psychologist and American Heart Association spokesman Barry J. Jacobs, PsyD, tells WebMD that the study adds to a growing body of research linking an optimistic attitude with better health.

“There is a lot of conjecture about why this is, but we don’t really know why optimism seems to be so beneficial for health,” he says.

Like Tindle and colleagues, many other researchers have found that negative thinkers make poorer lifestyle choices than positive thinkers. They also tend to suffer more from depression.

“Someone who believes that life is not worth living probably isn’t the type of person who goes to the gym three times a week,” Jacobs says.

But can someone who is pessimistic by nature change their tune to improve their health?

Psychiatrist Redford Williams, MD, who directs Duke University Medical Center’s Behavioral Medicine Research Center, believes they can.

Williams has devoted his career to teaching people how to overcome anger and hostility, and he is the author of the book Anger Kills: 17 Strategies for Controlling the Hostility That Can Harm Your Health.

In an interview with WebMD, Williams cited a 2005 Duke study showing that heart patients who attended a two-week, 12-hour workshop designed to teach such coping skills had less depression and better blood pressure control than heart patients who got a one-hour lecture on stress.

“People can learn these skills, and more and more research is showing that it can not only improve your life but save it,” he says.

Show Sources


Tindle, H.A. Circulation, Aug. 25, 2009; online.

Hilary A. Tindle, MD, MPH, assistant professor of medicine, University of Pittsburgh.

Barry J. Jacobs, PsyD, director of behavioral sciences, Drozer-Keystone Family Medicine Residency Program, Springfield, Pa; spokesman, American Heart Association.

Redford Williams, MD, director, Behavioral Medicine Research Center, Duke University Medical Center, Durham, N.C.

NHLBI Women’s Health Initiative, U.S. Department of Health and Human Services.

Bishop, G.D. American Heart Journal, 2005; vol 150: pp 602-610.

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