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Optimism and risk of incident hypertension: a target for primordial prevention

Epidemiology and psychiatric sciences, 2020-01, Vol.29, p.e157-e157, Article e157 [Peer Reviewed Journal]

Copyright © The Author(s), 2020. Published by Cambridge University Press ;2020 This article is published under (https://creativecommons.org/licenses/by/3.0/) (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;The Author(s) 2020 2020 The Author(s) ;ISSN: 2045-7960 ;EISSN: 2045-7979 ;DOI: 10.1017/S2045796020000621 ;PMID: 32792035

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  • Title:
    Optimism and risk of incident hypertension: a target for primordial prevention
  • Author: Kubzansky, Laura D. ; Boehm, Julia K. ; Allen, Andrew R. ; Vie, Loryana L. ; Ho, Tiffany E. ; Trudel-Fitzgerald, Claudia ; Koga, Hayami K. ; Scheier, Lawrence M. ; Seligman, Martin E. P.
  • Subjects: Adults ; Age ; Alcohol ; Armed forces ; Blood pressure ; Cardiovascular disease ; Computer centers ; Diabetes ; Disease prevention ; Ethnicity ; Family medical history ; Health care ; Hypertension ; Military personnel ; Optimism ; Original ; Original Articles ; Population ; Post traumatic stress disorder ; Psychiatry ; Smoking ; Womens health
  • Is Part Of: Epidemiology and psychiatric sciences, 2020-01, Vol.29, p.e157-e157, Article e157
  • Description: Abstract Aims Optimism is associated with reduced cardiovascular disease risk; however, few prospective studies have considered optimism in relation to hypertension risk specifically. We investigated whether optimism was associated with a lower risk of developing hypertension in U.S. service members, who are more likely to develop high blood pressure early in life. We also evaluated race/ethnicity, sex and age as potential effect modifiers of these associations. Methods Participants were 103 486 hypertension-free U.S. Army active-duty soldiers (mean age 28.96 years, 61.76% White, 20.04% Black, 11.01% Hispanic, 4.09% Asian, and 3.10% others). We assessed optimism, sociodemographic characteristics, health conditions, health behaviours and depression status at baseline (2009–2010) via self-report and administrative records, and ascertained incident hypertension over follow-up (2010–2014) from electronic health records and health assessments. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), and adjusted models for a broad range of relevant covariates. Results Over a mean follow-up of 3.51 years, 15 052 incident hypertension cases occurred. The highest v . lowest optimism levels were associated with a 22% reduced risk of developing hypertension, after adjusting for all covariates including baseline blood pressure (HR = 0.78; 95% CI = 0.74–0.83). The difference in hypertension risk between the highest v . lowest optimism was also maintained when we excluded soldiers with hypertension in the first two years of follow-up and, separately, when we excluded soldiers with prehypertension at baseline. A dose–response relationship was evident with higher optimism associated with a lower relative risk ( p < 0.001). Higher optimism was consistently associated with a lower risk of developing hypertension across sex, age and most race/ethnicity categories. Conclusions In a diverse cohort of initially healthy male and female service members particularly vulnerable to developing hypertension, higher optimism levels were associated with reduced hypertension risk independently of sociodemographic and health factors, a particularly notable finding given the young and healthy population. Results suggest optimism is a health asset and a potential target for public health interventions.
  • Publisher: Cambridge, UK: Cambridge University Press
  • Language: English;Italian
  • Identifier: ISSN: 2045-7960
    EISSN: 2045-7979
    DOI: 10.1017/S2045796020000621
    PMID: 32792035
  • Source: ProQuest One Psychology
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