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Is the association between optimistic cardiovascular risk perceptions and lower rates of cardiovascular disease
Robert Gramling1, Kathi L Heffner, William Mp Klein
1Department of Family Medicine, University of Rochester, 1381 South Avenue, Rochester, NY 14620, USA. Robert_Gramling@URMC.Rochester.edu.
Insights
Optimistic perceptions of cardiovascular disease risk in men are linked to lower death rates. This protective association is not explained by inflammation or endothelial dysfunction, suggesting a direct link between perception and health outcomes.
Area of Science:
- Cardiovascular epidemiology
- Psychosocial factors in health
- Biomarkers of disease
Background:
- Optimistic risk perception in men correlates with reduced cardiovascular mortality.
- The underlying reasons for this association remain unclear, with potential for causality or confounding by unmeasured factors.
- Inflammation and endothelial dysfunction are physiological processes implicated in cardiovascular disease.
Purpose of the Study:
- To investigate if inflammation or endothelial dysfunction markers confound the link between cardiovascular disease risk perception and outcomes.
- To elucidate the relationship between subjective risk assessment and objective cardiovascular health in men.
Main Methods:
- A nested case-cohort study design was employed using data from the Pawtucket Heart Health Program.
- C-reactive protein (CRP) and Vascular Endothelial Growth Factor (VEGF) levels were measured as biomarkers.
- Stratified analyses and logistic regression modeled potential confounding effects.
Main Results:
- Optimistic risk perception was associated with significantly lower odds of cardiovascular death (OR = 0.39).
- Neither CRP nor VEGF levels confounded this observed association.
- The findings indicate a robust link between perception and reduced mortality.
Conclusions:
- The cardio-protective effect of optimistic cardiovascular disease risk perception in men is not attributable to baseline inflammation or endothelial dysfunction.
- This suggests that psychological factors may play a direct role in cardiovascular health.
- Further research may explore the mechanisms driving this perception-outcome relationship.
Background:
More optimistic perceptions of cardiovascular disease risk are associated with substantively lower rates of cardiovascular death among men. It remains unknown whether this association represents causality (i.e. perception leads to actions/conditions that influence cardiovascular disease occurrence) or residual confounding by unmeasured factors that associate with risk perceptions and with physiological processes that promote cardiovascular disease (i.e. inflammation or endothelial dysfunction).
Purpose:
To evaluate whether previously unmeasured biological markers of inflammation or endothelial dysregulation confound the observed association between cardiovascular disease risk perceptions and cardiovascular disease outcomes;
Methods:
We conducted a nested case-cohort study among community-dwelling men from Southeastern New England (USA) who were interviewed between 1989 and 1990 as part of the Pawtucket Heart Health Program. We measured C-reactive protein (CRP) and Vascular Endothelial Growth Factor (VEGF) levels from stored sera for a random sample of the parent cohort (control sample, n = 127) and all cases of cardiovascular death observed through 2005 (case sample, n = 44). We evaluated potential confounding using stratified analyses and logistic regression modeling.
Results:
Optimistic ratings of risk associated with lower odds of dying from cardiovascular causes among men (OR = 0.39, 95% CI = 0.17, 0.91). Neither CRP nor VEGF confounded these findings.
Conclusions:
The strong cardio-protective association between optimistic ratings of cardiovascular disease risk and lower rates of cardiovascular mortality among men is not confounded by baseline biomarkers of systemic inflammation or endothelial dysfunction.
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