DON'T DESPAIR, MIDDLE-AGE MEN; PESSIMISM HIKES HEART DISEASE, STUDY SAYS.

Byline: Melissa Williams Associated Press 

Middle-age men who feel hopeless or think of themselves as failures may develop atherosclerosis, the narrowing of the arteries that leads to heart attacks and strokes, faster than their more optimistic counterparts, researchers report.

People who expressed high levels of despair had a 20 percent greater increase in atherosclerosis over four years, according to a report in the August issue of the American Heart Association journal Arteriosclerosis, Thrombosis and Vascular Biology.

``This is the same magnitude of increased risk that one sees in comparing a pack-a-day smoker to a nonsmoker,'' lead author Susan Everson said Monday.

``People need to recognize that this sense of giving up that many people feel has strong cardiovascular consequences. Steps should be taken to try to change their situation so they gain hope or become more optimistic,'' said Everson, an associate research scientist at the Human Population Laboratory of the Public Health Institute in Berkeley, Calif.

Earlier studies have associated hopelessness with heart disease, heart attack and death from heart disease. This latest study, however, sought to examine the influence of hopelessness earlier in the disease process, while the arteries were in the process of narrowing.

The findings, while not unexpected, are still noteworthy, said Dr. Marty Sullivan, a cardiologist and associate professor of medicine at Duke University Medical Center.

``This is one of the first studies of humans that has looked at the actual atherosclerosis process and has shown a strong relationship,'' he said. ``I am not surprised that we have now demonstrated that psychosocial factors may play a role.''

Atherosclerosis is a progressive disease in which fat, cholesterol, cellular waste products and calcium collect in the blood vessels, reducing their ability to deliver oxygen and nutrients.

Exactly how hopelessness speeds up artery narrowing isn't yet clear, Everson said. She noted that depression, anxiety and other types of psychological stress can affect the body's central nervous system, influencing the production of stress hormones.

For Everson's project, men participating in a larger heart-disease study in Finland were questioned about their outlook on life.

Ultrasound scans were used to measure their levels of artery narrowing at the start of the study and four years later.

The 20 percent greater increase in atherosclerosis levels in the most despondent group persisted even when researchers accounted for traditional coronary risk factors such as smoking and alcohol consumption, as well as the use of cholesterol-lowering and high-blood pressure medications, Everson said.

The rate of increase was particularly marked among men with early evidence of atherosclerosis and those with chronically high levels of despair.

``This indicates that hopelessness is probably an exacerbating mechanism,'' Everson said.