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

Autor:	Kubzansky LD; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.; Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Boehm JK; Department of Psychology, Chapman University, Orange, CA, USA., Allen AR; Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA., Vie LL; Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA., Ho TE; Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA.; Northrop Grumman Technology Services, Seaside, CA, USA., Trudel-Fitzgerald C; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.; Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Koga HK; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Scheier LM; Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA.; LARS Research Institute, Inc., Scottsdale, AZ, USA., Seligman MEP; Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA.
Jazyk:	angličtina
Zdroj:	Epidemiology and psychiatric sciences [Epidemiol Psychiatr Sci] 2020 Aug 14; Vol. 29, pp. e157. Date of Electronic Publication: 2020 Aug 14.
DOI:	10.1017/S2045796020000621
Abstrakt:	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.
Databáze:	MEDLINE
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