Abstract 1363: Objectively-assessed Positive Emotion is Associated With Reduced Incident Coronary Heart Disease: Canadian Nova Scotia Health Survey Population Study
Objective: Research has recently shown that positive emotions may protect against CHD. We examined whether objectively-assessed positive emotion is associated with a reduced risk of incident CHD independent of negative emotions in a population-based sample.
Methods: We measured positive and negative emotions in 1621 participants (806 men, 815 women) enrolled in the 1995 Nova Scotia Health Survey, a prospective population-based study of residents with no documented CHD at baseline. Using videotaped Extended Type A Structured Interviews, trained coders rated the degree to which the subject displayed positive emotions on a 5-point scale. Negative emotions were measured with the Center for Epidemiological Studies Depression Scale, the Cook Medley Hostility scale, and the Spielberger Trait Anxiety Inventory. Data on incident CHD events and deaths over ten years of follow-up were obtained from hospital records and death certificates. Cox proportional hazards models were used to assess the magnitude of the association.
Results: There were 129 (8.0%) incident CHD events (121 nonfatal, 8 fatal) during the 13,940 person-years of observation (incidence rate, 9.25 events/1000 person-years). Rater reliability for positive emotion was .90. Controlling for age, sex and Framingham CHD risk score, both positive emotional expression (adjusted hazard ratio [HR], 0.78; 95% confidence interval [CI], 0.65–0.94 per standard deviation; P=.011) and depressive symptoms (HR, 1.41; 95% CI 1.13–1.76 per standard deviation; P<.001) predicted CHD incidence; hostility and anxiety did not predict CHD (both p>.15).
Conclusion: In this large prospective population-based study, increased expression of positive emotions is protective against 10-year incident CHD, suggesting that preventive strategies may be enhanced by not only reducing depression but also by increasing positive emotion.