Pessimists have an increased risk of death from heart disease compared to optimists, a new study has found. Researchers from Finland found that those who died from coronary heart disease (CHD) had more of a pessimistic attitude compared to others, according to the study published in BCM Public Health Thursday.

Researchers initially hoped to improve the well-being and health of the local community when the study began in 2002. Nearly 3,000 men and women participated in the study after 4,272 were invited. By December 2013, the number of participants decreased due to death, deficiencies and other factors. In the end, the final sample during the 11-year follow-up included 2,267, 121 of which died from CHD, leaving 2,146 people alive.

“If you’re pessimistic and have some health issues, then it’s even more important to take care of your physical health,” Dr. Mikko Pankalainen, lead author of the study and a psychiatrist at the Paijat-Hame Central Hospital in Lahti, Finland said.

Smoking status, cholesterol levels, blood pressure, diabetes diagnosis and other personal information was recorded for the study. Subjects were asked to rate six statements on a scale from zero to four. The questionnaire asked participants how much the statements related to them. They were also asked to rate statements of optimism, such as “In uncertain times, I usually expect the best” and pessimism: “If something can go wrong for me, it will.”

Those who died from CHD were more pessimistic than the subjects who were still alive, results of the study found. However, there was no difference found about optimism in men and women and death rates.

A separate study that focused on women found those who experienced general mistrust of people or “cynical hostility” have a higher risk of heart disease compared to those who are more optimistic, Live Science reported. The women who were hostile experienced a lower heart rate variability compared to other women. Higher heart rate variability shows that the part of the nervous system that regulates heart rate is well balanced, said the lead author of that study.