Does inflammation mediate the effect of pessimism on coronary heart disease? A ten-year follow-up study
Abstract BackgroundCoronary heart disease (CHD) is a notable cause of mortality worldwide. Psychosocial factors have been confirmed to have an effect on the risk for cardiovascular diseases and gradually pessimism has also been recognized as a risk factor for CHD. The mechanism by which pessimism elevates the risk for CHD is unknown. According to one theory pessimism increases low-level inflammation and an elevated inflammation level has in turn been connected with an increased risk for CHD. However, the theory of inflammation working as a mediator between pessimism and the onset of CHD has yet to be proven.MethodsWe conducted a ten-year prospective cohort study on a regional sample of three cohorts aged 52–56, 62–66, and 72–76 years at baseline (N=2,815). A revised version of the Life Orientation Test was used at baseline to define the levels of dispositional optimism and pessimism. The level of inflammation was determined by measuring the level of C-reactive protein using high sensitivity assays. These results and the data of new cases of CHD during the follow-up were used in the statistical analyses. The mediation effect of C-reactive protein between pessimism and new cases of CHD was calculated.ResultsStudy subjects with a new case of CHD during the follow-up were more pessimistic and had higher C-reactive protein values at baseline than other study subjects. The pessimism score and C-reactive protein value correlated statistically significantly. We found that the connection between pessimism and developing CHD during the study period was partially mediated via the level of C-reactive protein.ConclusionPessimism seemed to be a substantial risk factor for developing CHD. Pessimism was connected with the level of inflammation. The theory that elevated inflammation level mediates indirectly the connection between pessimism and the risk for CHD could be proved partially. Consequently, other mediators between pessimism and CHD remain unclear.
