Journal
EUROPEAN HEART JOURNAL
Volume 31, Issue 9, Pages 1065-1070Publisher
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehp603
Keywords
Positive affect; Coronary artery disease; Depressive symptoms; Hostility; Anxiety
Categories
Funding
- National Institutes of Health, Bethesda, MD [HL-088117, HL-076857, HL-084034, HL-080665, HC25197, HL-04458]
- National Center for Research Resources (NCRR) [UL1 RR024156]
- National Health & Welfare of Canada
- Nova Scotia Department of Health
- Heart and Stroke foundation of Canada
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Positive affect is believed to predict cardiovascular health independent of negative affect. We examined whether higher levels of positive affect are associated with a lower risk of coronary heart disease (CHD) in a large prospective study with 10 years of follow-up. We examined the association between positive affect and cardiovascular events in 1739 adults (862 men and 877 women) in the 1995 Nova Scotia Health Survey. Trained nurses conducted Type A Structured Interviews, and coders rated the degree of outwardly displayed positive affect on a five-point scale. To test that positive affect predicts incident CHD when controlling for depressive symptoms and other negative affects, we used as covariates: Center for Epidemiological Studies Depressive symptoms Scale, the Cook Medley Hostility scale, and the Spielberger Trait Anxiety Inventory. There were 145 (8.3%) acute non-fatal or fatal ischaemic heart disease events during the 14 916 person-years of observation. In a proportional hazards model controlling for age, sex, and cardiovascular risk factors, positive affect predicted CHD (adjusted HR, 0.78; 95% CI 0.63-0.96 per point; P = 0.02), the covariate depressive symptoms continued to predict CHD as had been published previously in the same patients (HR, 1.04; 95% CI 1.01-1.07 per point; P = 0.004) and hostility and anxiety did not (both P > 0.05). In this large, population-based study, increased positive affect was protective against 10-year incident CHD, suggesting that preventive strategies may be enhanced not only by reducing depressive symptoms but also by increasing positive affect.
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