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

Kubzansky, L. D., Boehm, J. K., Allen, A. R., Vie, L. L., Ho, T. E., Trudel-Fitzgerald, C., Koga, H. K., Scheier, L. M. et Seligman, M. E. P. (2020). Optimism and risk of incident hypertension: A target for primordial prevention. Epidemiology and Psychiatric Sciences, 29 . ISSN 2045-7960 DOI 10.1017/S2045796020000621

Prévisualisation

PDF Disponible sous licence Creative Commons Attribution. Télécharger (319kB) | Prévisualisation

Résumé

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.

Type de document:	Article
Mots-clés libres:	Attitudes Epidemiology Health outcomes Mental health Prospective study
Date de dépôt:	22 mai 2025 17:15
Dernière modification:	22 mai 2025 17:18
Version du document déposé:	Version officielle de l'éditeur
URI:	https://depot-e.uqtr.ca/id/eprint/11971

Actions (administrateurs uniquement)

Éditer la notice