Effects of optimism in adolescence on cardiovascular event risk in adulthood


Srinivas, Sharan; Anand, Kavin; & Chockalingam, Anand (2019). Effects of optimism in adolescence on cardiovascular event risk in adulthood. American College of Cardiology 68th Annual Scientific Sessions. New Orleans, LA: American College of Cardiology.


Background Genes, socio-economic factors and childhood adversity may affect outlook towards life in formative adolescent years. An optimistic outlook may blunt the effects of these early influences, leading to positive biological and lifestyle choices thereby reducing cardiovascular events (CVE). Methods We examined the Add Health database, which conducted a series of surveys and health tests (Wave 1 - 1994; Wave 2 - 1996, Wave 3 - 2001; Wave 4 - 2008) on a representative sample of US individuals from adolescence to adulthood. Optimism in adolescence was measured based on specific Wave 1 survey questions identified by psychiatrists. A factor analysis confirmed the presence of one-factor component structure - optimism (i.e., only one factor with an eigenvalue > 1). Further, reliability analysis indicated good internal consistency (α = 0.74). Thus, a composite variable, optimism, was created by combining the chosen items. The 30-year CVE risk was estimated based on risk factors (age, gender, BMI, use of hypertensive medications, smoking status) and health tests (blood pressure, diabetes) in adulthood (Wave 4). Regression analysis was conducted to assess the impact of optimism on CVE risk after controlling for obesity, medical conditions, sociodemographic and socioeconomic factors in adolescence. Results Among 11,000 adolescents (mean age of 16 years, 52% women), high level of optimism was noted in 30%. Based on follow-up data, the mean 30-year CVE risk in adulthood was 13±9%. Females had lower CVE risk (8±0.2%, p-value < 0.001), while African Americans and American Indians had a higher risk compared to Caucasians (1±0.1% and 3±0.6%, respectively, p-value < 0.001). Regression analysis indicated that adolescence optimism is significant and negatively correlated with adulthood CVE risk (-0.6±0.1%, p < 0.001). Adolescence obesity, economic hardships and prior medical conditions significantly increased adulthood CVE risk (9±0.2%, 0.7±0.1%, 2±0.4%, respectively; p-value < 0.001 for all). Conclusion Obesity in adolescence strongly predicts CVE. An optimistic outlook may counter the CVE risk related to economic hardships. Optimism in adolescence independently reduces CVE in adulthood.



Reference Type

Conference proceeding

Book Title

American College of Cardiology 68th Annual Scientific Sessions


Srinivas, Sharan
Anand, Kavin
Chockalingam, Anand

Year Published


Volume Number





American College of Cardiology

City of Publication

New Orleans, LA



Reference ID