{
  "abstract": "Introduction Hopelessness is associated with higher risk of death and myocardial infarction in middle-aged men, independent of depression. The first UK trial of home-based IV diuretic treatment for acute heart failure (HF) found patients randomized to outpatient care experienced a rise in Adult State Hope Score within 30 days. However, by 60 days, hope declined, potentially due to increased hospital admissions. This systematic review explores whether hope influences cardiovascular outcomes across diverse patient groups.Methods A systematic review was conducted following PRISMA guidelines. PubMed, Ovid MEDLINE, EMBASE and Web of Science were searched to identify studies examining hope as a predictor of outcomes in cardiovascular disease (CVD) populations. Inclusion criteria required studies measuring hope and at least one cardiovascular, behavioural or psychological outcome. Studies without explicit hope measurements were excluded. Data was extracted and synthesised narratively.Results One-hundred-and-nine records were retrieved from database search and 17 full text articles reviewed. Twelve studies, with a total of 5540 patients (63.1% male) were included. The mean age was 60.4 (SD 11.5). Patient cohorts included adults diagnosed with coronary heart disease, stroke, and individuals undergoing pre- and post-operative care for valvular heart disease.Three studies recorded cardiovascular outcomes. One cohort study of 2,482 men found hopelessness was associated with a 6-fold higher cardiovascular mortality risk in individuals with pre-existing CVD and a 2.3-fold higher risk in those without CVD. A study of a female cohort found higher levels of hope were protective against first-onset angina, independent of other psychological factors. In stroke patients, higher hope significantly negatively correlated with post-stroke fatigue (r = –0.765, p < 0.01).Behavioural outcomes, such as self-management, were found to significantly correlate with higher hope scores (r = 0.671, P < 0.05) for patients post-percutaneous coronary intervention. Hope showed a moderate correlation with self-care activation (r = 0.395, p < 0.01) and negative correlation with medication nonadherence (r = -0.268, p < 0.01).Among six studies reporting psychological outcomes, higher hope was linked to lower depression and anxiety levels, enhanced resilience, and improved quality of life.Conclusions This review highlights positive impact of hope on cardiovascular, psychological and behavioural outcomes in CVD. Psychosocial interventions for patients with HF have already been shown to impact depression, anxiety and quality of life. Hope is felt to be a meaningful outcome for our patient-public involvement group representative. Integrating hope-enhancing interventions may play a key role in reducing ischaemic burden. Collaboration with chaplaincy services may enhance holistic care. Future research should explore randomised control trials targeting hope to improve CVD outcomes.Abstract 3-011 Figure 1Prisma diagramAbstract 3-011 Table 1Outcomes reported by included studies Outcome category Participants (n) Studies reporting outcome (n) Outcomes reported Cardiovascular 2528 2 Presence/ absence of first onset angina; cardiovascular and non-cardiovascular mortality; incidence of myocardial infarction Behavioural 390 2 Medication adherence and non-adherence; self-management Psychological 2142 6 Quality of life; depressive symptoms; anxiety symptoms including death anxiety; psychological resilience Cardiovascular and psychological 340 1 Post stroke-fatigue; discharge readiness Behavioural and psychological 40 1 Quality of life; health work References Everson S, et al. 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Factors associated with hope and quality of life in patients with coronary artery disease. The Journal of Nursing Research 2022;30(2):e200.Sun B, Wang N, Li K, Yang Y, Zhang F. The mediating effects of hope on the relationships of social support and self-esteem with psychological resilience in patients with stroke. BMC Psychiatry 2024;24:340.Heshmati R, Jafari E, Salimi Kandeh T, Caltabiano M. Associations of Spiritual Well-Being and Hope with Health Anxiety Severity in Patients with Advanced Coronary Artery Disease. Medicina 2021;57(10):1066.Bluvol A, Ford-Gilboe M. Hope, health work and quality of life in families of stroke survivors. Journal of Advanced Nursing 2004;48(4):322–332.Chernoff Robert Alan, JD; Messineo Gabrielle; Kim Sungjin; Pizano Demetria; Korouri Samuel; Danovitch Itai; IsHak Waguih William, FAPA. 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  "authors": [
    {
      "affiliations": [
        "University Hospitals Sussex NHS Foundation Trust"
      ],
      "name": "Riya Rajendran"
    },
    {
      "affiliations": [
        "School of Dentistry, Institute of Life Course and Medical Sciences, Faculty of Health and Life Sciences, University of Liverpool"
      ],
      "name": "Alexander Montasem"
    },
    {
      "affiliations": [
        "Patient Public Involvement Group for Research and Quality Improvement, Lancashire Cardiac Centre, Blackpool Teaching Hospitals NHS Foundation Trust"
      ],
      "name": "Grace Wong"
    },
    {
      "affiliations": [
        "Lancashire Cardiac Centre, Blackpool Teaching Hospitals NHS Foundation Trust",
        "Liverpool Centre for Cardiovascular Science, University of Liverpool"
      ],
      "name": "Kenneth Wong"
    }
  ],
  "title": "3-011 The impact of hope on cardiovascular disease: a systematic review",
  "uid": "bc4463e1-a1bf-57fa-b340-c397e7282a53"
}