Thursday, March 13, 2008

Pessimistic heart patients have higher risk of death
By Kelly Winget

A new study by Duke University and DCRI researchers found that cardiac patients who had negative outlooks about their recovery were twice as likely to die earlier than patients who had more optimistic views.

The study is one of the first to analyze how much a patient's attitude about their cardiovascular health can impact their longterm health and survival. The findings of the study were presented at the American Psychosomatic Society's Annual Scientific Conference this week.

For the study, more than 2.800 patients with coronary artery disease were asked to complete a psychological questionnaire, focusing on their expectations about recovering from the disease and returning to their normal routine. Study participants had at least one blocked artery.

Six to 10 years after enrolling in the study, 978 patients had died and 66 percent of those deaths were due to coronary artery disease. Those who had more negative expectations about their recovery had a higher risk of death, despite the severity of the coronary disease; age; gender; income; depressive symptoms and the ability to complete routine tasks when they were hospitalized.

“We already know that there is a relationship between depression and increased rates of mortality,” said Duke professor John Barefoot, Ph.D, lead author of the study. “These findings demonstrate the magnitude of the impact of patient expectations on the recovery process, regardless of other psychological or social factors.”

Researchers said the study indicates that physicians need to consider their patients' beliefs and expectations as part of the recovery process. For patients, researchers noted that having positive expectations can make you feel better and may help you live longer.

The research team noted that further research is necessary to determine how positive expectations impact disease survival. One theory is that patients with positive outlooks might have better coping behaviors, such as following all of their doctors' orders.

Previous studies have examined how patient expectations impact their ability to engage in daily activities, such as returning to work and exercising. This new study expanded that to include the impact on physical health.

DCRI researchers involved in the study include Nancy Clapp-Channing and Daniel Mark, MD.