Examining Optimism, Psychosocial Risks, and Cardiovascular Health Using Life's Simple 7 Metrics in the Multi-Ethnic Study of Atherosclerosis and the Jackson Heart Study

Abstract

Background: Optimism has been shown to be positively associated with better cardiovascular health (CVH). However, there is a dearth of prospective studies showing the benefits of optimism on CVH, especially in the presence of adversities, i.e., psychosocial risks. This study examines the prospective relationship between optimism and CVH outcomes based on the Life's Simple 7 (LS7) metrics and whether multilevel psychosocial risks modify the aforementioned relationship.Methods: We examined self-reported optimism and CVH using harmonized data from two U.S. cohorts: Multi-Ethnic Study of Atherosclerosis (MESA) and Jackson Heart Study (JHS). Modified Poisson regression models were used to estimate the relationship between optimism and CVH using LS7 among MESA participants (N = 3,520) and to examine the relationship of interest based on four biological LS7 metrics (body mass index, blood pressure, cholesterol, and blood glucose) among JHS and MESA participants (N = 5,541). For all CVH outcomes, we assessed for effect measure modification by psychosocial risk.Results: Among MESA participants, the adjusted risk ratio (aRR) for ideal or intermediate CVH using LS7 comparing participants who reported high or medium optimism to those with the lowest level of optimism was 1.10 [95% Confidence Interval (CI): 1.04–1.16] and 1.05 (95% CI: 0.99–1.11), respectively. Among MESA and JHS participants, the corresponding aRRs for having all ideal or intermediate (vs. no poor) metrics based on the four biological LS7 metrics were 1.05 (0.98–1.12) and 1.04 (0.97–1.11), respectively. The corresponding aRRs for having lower cardiovascular risk (0–1 poor metrics) based on the four biological LS7 metrics were 1.01 (0.98–1.03) and 1.01 (0.98–1.03), respectively. There was some evidence of effect modification by neighborhood deprivation for the LS7 outcome and by chronic stress for the ideal or intermediate (no poor) metrics outcome based on the four biological LS7 metrics.Conclusion: Our findings suggest that greater optimism is positively associated with better CVH based on certain LS7 outcomes among a racially/ethnically diverse study population. This relationship may be effect measure modified by specific psychosocial risks. Optimism shows further promise as a potential area for intervention on CVH. However, additional prospective and intervention studies are needed.

Life satisfaction and ideal cardiovascular health score: A cross-sectional study from ELSA-Brasil.

“…Our results are in line with findings from a cross-sectional analysis with individuals aged 18–85 years, in which low life satisfaction (≤1 on a scale from 0 to 4) was associated with a lower chance of achieving optimal and intermediate levels of global ideal CVH in women (Mathews et al, 2018). Although few studies have investigated the association of life satisfaction with global ideal CVH, previous longitudinal studies showed consistent associations of positive affect (Boehm et al, 2020), subjective well-being (Boehm et al, 2017), and high levels of optimism (Park et al, 2021; Sims et al, 2019) with higher levels of ideal CVH, even after adjustments for sociodemographic characteristics and depression. This evidence suggests that higher levels of life satisfaction can contribute to improving CVH.…”

“…A cross-sectional study found an inverse association between life satisfaction and the Framingham Risk Score in Polish adults (Lopuszan ́ska et al, 2013). Furthermore, the way to analyze the ideal CVH score varies among studies: some use the global score, while others assess the lifestyle and biological subscales separately (Mathews et al, 2018;Park et al, 2021). Studies using subscales indicate that there may be differences in associations, especially in outcomes of a subjective or mental/cognitive health nature (Gaye et al, 2016;Sabia et al, 2019).…”

Always Look on the Bright Side: Associations of Optimism With Functional Outcomes After Stroke

“…There has been a positive association between optimism and better health behaviors, including better dietary and physical activity habits. 20 , 21 In addition, associations between optimism and physical function are found in multiple pathophysiologic mediators of chronic disease, including inflammation, impairments in endothelial function, metabolic activity, blood pressure, ambulatory blood pressure, and hypothalamic‐pituitary‐adrenocortical function. 22 …”

Proteomic Mediators of Overall Cardiovascular Health on All-Cause Mortality

“…Since the establishment of the LS7, studies have developed scoring algorithms that classify and categorize study subjects based on achieving these established goals [ 2 ]. Better cardiovascular health (CVH), as assessed by the LS7, has shown protective associations with all-cause and cardiovascular mortality [ 3 , 4 , 5 ], incidence of cardiovascular events [ 2 , 6 ], cancer risk [ 2 ], aging-related declines in physical [ 7 , 8 ] and cognitive function [ 9 , 10 , 11 ], frailty [ 12 ], and psychosocial health and depression [ 13 , 14 , 15 ]. Taken together, these findings suggest that CVH captures biological age, and this notion is also supported by CVH being associated with the epigenetic clock [ 16 , 17 ], one of the widely studied molecular biomarkers of biological age.…”