Comparative optimism among patients with coronary heart disease (CHD) is associated with fewer adverse clinical events 12 months later.

The current study evaluates the levels of comparative optimism among patients with coronary heart disease (CHD) and examines its relationship to health outcomes 12 months later. 164 patients completed self-report questionnaires at the end of cardiac rehabilitation and the number of adverse clinical events in the following 12 months were recorded. Comparative optimism was assessed in relation to a typical other who has not had cardiac event, a typical other who has had the same cardiac event as the respondent, and a typical member of the cardiac rehabilitation class. Clinical-demographic details and distress were assessed. Participants were comparatively optimistic in all three ratings. Logistic regression (controlling for age, gender, co-morbidities, and distress) revealed that higher levels of adverse events were associated with older age, being male, and lower levels of overall comparative optimism. Comparative optimism was associated with decreased risk of adverse clinical events in the year following cardiac rehabilitation attendance.

Rates of smoking in the households of cardiac patients.

BACKGROUND: Non-smokers who live with smokers are at increased risk for coronary heart disease (CHD). However, such a risk may be increased if the non-smoker is a patient with established CHD. The present study assessed the percentage of cardiac rehabilitation patients who share a household with regular smokers. METHODS: One hundred and three consecutive cardiac patients attending a hospital-based outpatient 10-week multidisciplinary cardiac rehabilitation programme completed a questionnaire to assess the smoking behaviour of cardiac patients and the smoking behaviour of others in the patient's household. RESULTS: Forty percent of the present sample reported sharing a household with someone else who smoked. The single most common smoker in the household was the patient's spouse (36%), followed by son (12%), daughter (12%) and son and daughter (12%). Of those living with a smoker, only 15% reported that the smoker did not smoke in their presence. Thus, 85% of cardiac patients living in a house where somebody smoked were regularly exposed to environmental smoke. CONCLUSION: A substantial number of cardiac patients may be exposed to environmental smoke in the household. Interventions to modify the lifestyle behaviour of other members of the cardiac patient's household may be warranted in order to achieve optimum secondary prevention.