Association of pessimism with cardiovascular events and all-cause mortality

Poor psychological health is associated with Takotsubo cardiomyopathy, cardiac syndrome X, coronary microcir-culatory dysfunction, peripheral artery disease, or spontaneous coronary artery dissection. Data regarding pessi-mism, cardiovascular disease (CVD) events and mortality and all-cause mortality remained inconclusive. This systematic review and meta-analysis aim to provide an overview of the association between pessimism, CVD out-comes and mortality. A systematic search of electronic databases was conducted from inception through July 2022 for studies evaluating pessimism and adverse outcomes. A total of 17 studies published between 1966 and July 2022 met our inclusion criteria, for a total of 232,533 individuals. Pooled hazard ratios were calculated in random-effects meta-analyses. Based on pooled analysis of adjusted HRs, pessimism was associated with ad-justed HR of 1.13 (95% CI 1.07-1.19) for all-cause mortality with minimal heterogeneity (I2 = 28.5%). Based on pooled analysis of adjusted HRs, pessimism was associated with adjusted HR of 1.30 (95% CI 0.43-3.95) for CHD mortality, adjusted HR of 1.41 (95% CI 1.05-1.91) for CVD mortality, and adjusted HR of 1.43 (95% CI 0.64-3.16) for stroke. In conclusion, pessimism seems to be significantly associated with a higher risk for and poorer outcomes from CVD events than optimistic styles. There are genetic and other bases for these life ap-proaches, but behavioral, cognitive and meditative interventions can modify patients' level of pessimism, hope-fully leading to better medical outcomes. Testing this theory would yield highly useful and practical data for clinical care.(c) 2022 Elsevier Inc. All rights reserved.