title: Positive affect is not associated with incidence of cardiovascular disease: a population-based study of older persons.
abstract: BACKGROUND
  The relationship between positive psychological well-being (PPWB) and cardiovascular disease (CVD) is inconsistent across different CVD outcomes and for different PPWB constructs, such as positive affect. In addition, the relationship between PPWB and CVD as a composite measure is rarely assessed.
  
  
  OBJECTIVE
  To assess whether positive affect is protective of incident CVD.
  
  
  METHODS
  Positive affect was assessed in two cohorts between 1993 and 2001 in Rotterdam using relevant questions from the Center for Epidemiological Studies Depression (CES-D) scale and the Hospital Anxiety and Depression Scale (HADS; in a sub-sample) in 6349 non-demented, CVD-free, consenting adults, aged 55+years. Composite CVD was defined as stroke, heart failure and coronary heart disease, which were continuously monitored through medical records until 1st April 2010.
  
  
  RESULTS
  There were 1480 (23.3%) first time CVD events during follow-up (11.9 ± 2.8 SD years, 58,416 person-years). Positive affect was not associated with incident CVD (CES-D HR: 1.00 per point, 95% CI: 0.98-1.02; HADS HR: 0.98, 95% CI: 0.92-1.05). Stratification by age or sex and assessment of separate CVD outcome did not change results.
  
  
  CONCLUSIONS
  In this large, population-based study, there was no association between positive affect and twelve-year incident CVD in older adults who were free of diagnosed CVD at baseline.
authors: Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. Electronic address: Rosanne.Freak-Poli@monash.edu.
authors: Rosanne
authors: R
authors: Freak-Poli
authors: Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors: Saira Saeed
authors: SS
authors: Mirza
authors: Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors: Oscar H
authors: OH
authors: Franco
authors: Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Neurology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Radiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors: M Arfan
authors: MA
authors: Ikram
authors: Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors: Albert
authors: A
authors: Hofman
authors: Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Child and Adolescent Psychiatry, Erasmus Medical Centre, The Netherlands; Department of Psychiatry, Erasmus Medical Centre, The Netherlands.
authors: Henning
authors: H
authors: Tiemeier
mesh_terms: D000339:Affect; D000368:Aged; D001008:Anxiety Disorders; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D003866:Depressive Disorder; D005260:Female; D006240:Happiness; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010549:Personal Satisfaction; D011159:Population Surveillance; D065840:Protective Factors; D012307:Risk Factors
keywords: Cardiovascular disease; Coronary heart disease; Happiness; Heart failure; Positive affect; Stroke; Well-being