Heart attack patients with a positive attitude are more likely to make lifestyle changes that increase their odds of recovery.

A growing body of research strongly suggests that a positive attitude can improve a patient’s chances of recovering from major medical events such as a heart attack. Now we and other researchers are trying to determine precisely why that is and how we can help more patients benefit.

Having a heart attack or other major heart condition is a watershed moment.

More than 2.5 million people are hospitalized for heart attacks every year in the United States. Twenty percent of these patients are hospitalized again or die during the next year. Finding ways to improve attitudes after a heart attack could have a major impact on the survival rate.

In our practices at Massachusetts General Hospital, we see again and again that having a heart attack or other major heart condition is a watershed moment. Some people thrive after the event and make substantial lifestyle changes — becoming more active, following a healthier diet, quitting smoking. Others end up feeling discouraged and do not make changes.

We recently completed a study that was the first to examine how positive attitudes can impact specific behavior. For it, we surveyed 164 Mass General patients two weeks after they had had a heart attack, asking them to define their attitude. Then, we measured each individual patient’s physical activity over the next six months – the most critical period for cardiac recovery.

Taking Action After a Heart Attack

Our study was the first attempt to examine the impact of specific behavior among such patients. What we learned is that being optimistic improves your recovery and reduces risk, above and beyond all other factors including family history. Being grateful did not seem to have the same effect. Our results suggest that the perks of a positive outlook may be more related to actions people take rather than simply feeling grateful for surviving the heart attack.

Tips to Become More Optimistic

  • Accentuate the positive. Recall and savor good events in your life. When confronted with difficulties, identify lessons learned, experience gained or hidden benefits. Take concrete steps toward making good things happen.
  • Take control. Optimists tend to be take-charge people and that leads to a greater sense of control over situations like having a medical illness. Think about what to do and how you can contribute to a good outcome.
  • Be realistic. Contrary to popular belief, optimists do not sugarcoat the world. Try to see situations with all of their bad and good components in a clear-eyed manner. Take situations head-on by addressing the hard parts that can be addressed and by making specific plans to make a good outcome more likely.

We learned that patients who are optimistic exercised significantly more as they recovered. This often kept them healthier and out of the hospital in the months that followed. Patients who felt more optimistic shortly after the heart attack had an 8-percent lower risk of readmission over the next six months than their peers who had been less hopeful.

The Happy Heart

This study is just the beginning. We are exploring several ways to help boost optimism among heart attack patients. Our new study — Positive Emotions in Acute Coronary Events (PEACE) — explores whether performing positive activities helps people feel ready, willing and able to become more physically active after a heart attack.

In this study, a trainer combines physical exercise goals with positive activities such as performing acts of kindness or recalling past success. Our goal is to determine whether such an approach will lead to happier feelings, more exercise and better overall heart health.

For more information about how you can support these studies, please contact us.

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Jeff C. Huffman, MD, is the director of the Cardiac Psychiatry Research Program at Mass General in the Division of Psychiatry and Medicine where he acts as principal investigator for eight studies spanning psychology, health behavior and cardiovascular disease. He also serves as the medical director of the Inpatient Psychiatry Service at Mass General.

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Hanna K. Gaggin, MD, MPH, is a cardiologist, educator and clinical research scientist specializing in the application of biology-based science and evidence-based medicine. Dr. Gaggin oversees the design and operation of clinical cardiac trials at the Corrigan Minehan Heart Center at Mass General.

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James L. Januzzi, MD, is the Hutter Family Professor of Medicine at Harvard Medical School, the director of the Dennis and Marilyn Barry Fellowship in Cardiology Research at Massachusetts General Hospital, and Senior Faculty at Harvard Clinical Research Institute. He is an internationally recognized clinical trialist, and a world expert on cardiac biomarker testing in cardiovascular diseases. He has served as the cardiology consultant to the Boston Red Sox since 2005.