Everson S, Kaplan G, Goldberg DE, Salonen R, Salonen JT. Hopelessness and 4-year progression of carotid atherosclerosis. Arteriosclerosis, Thrombosis, and Vascular Biology 1997; 17 (8): 1490-5.

This study focuses on hope and its lack, as a factor leading to progression of atherosclerosis in the carotid arteries leading to the brain. Researchers looked at carotid arteries by ultrasound and found that traditional risk factors for coronary (heart) atherosclerosis, and the use of cholesterol-lowering and high blood pressure-lowering drugs did not account for the differences observed among the population of middle-aged men studied. A high level of reported hopelessness in the men studied exacerbated the progressing of atherosclerosis. Other studies have shown similar findings with cancer and myocardial infarction. These results point to the strong influence of psychosocial factors on health. 

Abstract

The importance of hope has long been recognized, whereas a lack of hope, or "giving up," is generally believed to have a negative impact on psychological well-being and physical health. Recently, hopelessness has been identified as a strong, independent predictor of cardiovascular disease morbidity and mortality in both American and Finnish populations. In this study we examined the association between high levels of hopelessness and progression of carotid atherosclerosis in participants (n = 942) in the Kuopio Ischemic Heart Disease Study, a population-based study of middle-aged men from eastern Finland who underwent carotid ultrasonography at baseline and 4 years later. Men reporting high levels of hopelessness at baseline had faster progression of carotid atherosclerosis, assessed by four measures of intima-media thickening (IMT), than men reporting low to moderate levels of hopelessness. Further analyses revealed significant interactions between hopelessness and initial level of atherosclerosis, such that the effects of high hopelessness on progression were greatest among men who had baseline mean IMT values at or above the median. Moreover, progression was greatest among men reporting high levels of hopelessness at both baseline and follow-up. Traditional coronary risk factors and use of cholesterol-lowering and antihypertensive medications did not account for much variance in the observed relationships. These findings indicate that hopelessness contributes to accelerated progression of carotid atherosclerosis, particularly among men with early evidence of atherosclerosis, and that chronically high levels of hopelessness may be especially detrimental. Additional research is needed to identify the contributory pathways and/or mechanisms underlying these relationships.

Keywords

• atherosclerosis
• heart disease
• hopelessness
• psychosocial factors
• risk factor