title: Don't worry, be happy: positive affect and reduced 10-year incident coronary heart disease: the Canadian Nova Scotia Health Survey.
abstract: OBJECTIVE
  Positive affect is believed to predict cardiovascular health independent of negative affect. We examined whether higher levels of positive affect are associated with a lower risk of coronary heart disease (CHD) in a large prospective study with 10 years of follow-up.
  
  
  RESULTS
  We examined the association between positive affect and cardiovascular events in 1739 adults (862 men and 877 women) in the 1995 Nova Scotia Health Survey. Trained nurses conducted Type A Structured Interviews, and coders rated the degree of outwardly displayed positive affect on a five-point scale. To test that positive affect predicts incident CHD when controlling for depressive symptoms and other negative affects, we used as covariates: Center for Epidemiological Studies Depressive symptoms Scale, the Cook Medley Hostility scale, and the Spielberger Trait Anxiety Inventory. There were 145 (8.3%) acute non-fatal or fatal ischaemic heart disease events during the 14 916 person-years of observation. In a proportional hazards model controlling for age, sex, and cardiovascular risk factors, positive affect predicted CHD (adjusted HR, 0.78; 95% CI 0.63-0.96 per point; P = 0.02), the covariate depressive symptoms continued to predict CHD as had been published previously in the same patients (HR, 1.04; 95% CI 1.01-1.07 per point; P = 0.004) and hostility and anxiety did not (both P > 0.05).
  
  
  CONCLUSIONS
  In this large, population-based study, increased positive affect was protective against 10-year incident CHD, suggesting that preventive strategies may be enhanced not only by reducing depressive symptoms but also by increasing positive affect.
authors.affiliation: Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, 622 West 168th Street, PH9 Room 948, New York, NY 10032, USA. kd2124@columbia.edu
authors.forename: Karina W
authors.initials: KW
authors.lastname: Davidson
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Mostofsky
authors.forename: William
authors.initials: W
authors.lastname: Whang
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D001007:Anxiety / Q000453:epidemiology; D003327:Coronary Disease / Q000453:epidemiology / Q000523:psychology*; D003866:Depressive Disorder / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006791:Hostility; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009674:Nova Scotia / Q000453:epidemiology; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents