Cardiovascular risk in midlife and psychological well-being among older men

Negative and positive affects influence the prognosis in the elderly, but underlying mechanisms are obscure. We investigated whether cardiovascular disease risk in midlife is related to psychological well-being in older men (aged 69-84 years old).

A socioeconomically homogeneous volunteer sample of men, born from 1919 through 1934, was followed up for 29 years. At baseline in 1974, they were healthy but considered to be at low (n = 593) or high (n = 610) risk of cardiovascular diseases (repeatedly 1 or more of classic cardiovascular risk factors). From November 1, 2002, through March 31, 2003, a mailed questionnaire was used to assess psychological well-being in older survivors. Mortality up to December 31, 2002, was retrieved from national registers.

During the entire follow-up, 303 men died, 127 (21.4%) and 176 (28.9%) in the low- and high-risk groups, respectively (hazard ratio, 1.54; 95% confidence interval, 1.19-2.00; P = .001). From 2002 through 2003, the response rates were 73.7% (336/456) and 71.4% (297/416) in the low- and high-risk groups, respectively (P = .45), and the mean age was 76 years. The variables related to psychological well-being were consistently better in the low-risk than in the high-risk group as they became older. The differences were observed especially in life satisfaction (P = .02), feeling of happiness (P = .001), positive life orientation as a whole (P = .04), and the Zung depression score (P = .007). The difference in the feeling of happiness between the groups prevailed (P = .01) after adjustments, including the feeling of depression.

Low cardiovascular risk in midlife was associated not only with better survival but also with better psychological well-being in the elderly.