If you think you have a lower risk of dying of heart disease you are probably right, according to a new study. Men who felt their risk of heart disease was low had a death rate that was only one-third that of their less optimistic counterparts. The findings did not apply to women.

The message here is definitely not, ‘Don't worry, be happy.’

There have been many studies on the effect of stress on people. In short, it's bad for them. Much less research has been done on the effect of a patient's outlook on his or her medical outcome. A recent study done at Brown University indicates that having a positive outlook can improve that outcome. The results of the study were published in the July/August issue of the Annals of Family Medicine. Men who felt they were at average risk for heart disease had a death rate from cardiovascular disease triple that of those who felt they were only at low risk. This effect was not seen in women. The study took place over a 15 year period.

The message here is definitely not "Don't worry, be happy." Dr. Robert Gramling, who headed the study, says that it should not be taken as a license to ignore what your doctor tells you about risk factors like cholesterol, obesity and smoking. But a positive attitude doesn't seem to hurt. Dr. Gramling is now assistant professor of family medicine at the University of Rochester, in New York, and is currently working on experiments to better determine under what conditions optimism is most helpful to a patient.

Dr. Gramling thinks that physicians could do a much better job of describing risk and risk factors to their patients. Physicians often have a pessimistic bias in uncertain medical situations, and may be communicating that bias to the patients. He says that a high-risk classification often strikes fear into a patient, "and I would suggest that fear-based prevention...is not as helpful as holding an optimistic view. We should focus on helping make changes easy to do, rather than on making people more fearful."

Dr. Gramling also thinks that the lack of effect seen in women can be traced to the era when the study was begun. Today we know that cardiovascular disease is the leading cause of death in American women, as well as men. In the early 1990s, it was thought to be less of a risk for women, and being described as high risk may not have seemed as threatening to women as to men.

There is still a great deal that remains unknown about the relationship between mind and body. Having a positive outlook certainly can't hurt you and may very well be beneficial, as long as it doesn't serve as a substitute for prevention, treatment and healthy habits.