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The Reply

      We thank Dr Ito for his interest in our systematic review and meta-analysis.
      • Krittanawong C
      • Maitra NS
      • Hassan Virk HU
      • et al.
      Association of optimism with cardiovascular events and all-cause mortality: systematic review and meta-analysis.
      Dr Ito points out that optimism is a nonpermanent mental state, which changes over time. Indeed, we agreed that multiple measurements to achieve accurate matrices is needed in optimism measurement. Unfortunately, most included study did not measure optimism multiple times; we, therefore, agreed this would be a limitation in this kind of studies related to nonpermanent mental state. Readers should take into account the possible fluctuation of optimism over time. Future studies on novel methods or biomarkers reflecting mental health state or traits of optimism may be needed.

      Reference

        • Krittanawong C
        • Maitra NS
        • Hassan Virk HU
        • et al.
        Association of optimism with cardiovascular events and all-cause mortality: systematic review and meta-analysis.
        Am J Med. 2022; 135: 856-863.e2https://doi.org/10.1016/j.amjmed.2021.12.023