Over the last few decades numerous studies have shown negative states, such as depression, anger, anxiety, and hostility, to be detrimental to cardiovascular health. Less is known about how positive psychological characteristics are related to heart health. In the first and largest systematic review on the topic, Harvard School of Public Health (HSPH) researchers found a connection between psychological well-being and a reduced risk of heart attacks, strokes, and other cardiovascular events.

The study was published online April 17 in Psychological Bulletin.

More than 2,200 Americans die of cardiovascular disease (CVD) each day, an average of one death every 39 seconds, according to the American Heart Association. Stroke accounts for about one of every 18 U.S. deaths.

“The absence of the negative is not the same thing as the presence of the positive. We found that factors such as optimism, life satisfaction, and happiness are associated with reduced risk of CVD regardless of such factors as a person’s age, socioeconomic status, smoking status, or body weight,” said lead author Julia Boehm, research fellow in the Department of Society, Human Development, and Health at HSPH. “For example, the most optimistic individuals had an approximately 50 percent reduced risk of experiencing an initial cardiovascular event compared to their less optimistic peers,” she said.

In a review of more than 200 studies published in two major scientific databases, Boehm and senior author Laura Kubzansky, associate professor of society, human development, and health at HSPH, found that there are psychological assets, such as optimism and positive emotion, that afford protection against cardiovascular disease. It also appears that these factors slow the progression of disease.

To further understand how psychological well-being and CVD might be related, Boehm and Kubzansky investigated well-being’s association with cardiovascular-related health behaviors and biological markers. They found that individuals with a sense of well-being engaged in healthier behaviors such as exercising, eating a balanced diet, and getting sufficient sleep. In addition, greater well-being was related to better biological function, such as lower blood pressure, healthier lipid (blood fat) profiles, and normal body weight.

“These findings suggest that an emphasis on bolstering psychological strengths rather than simply mitigating psychological deficits may improve cardiovascular health,” Kubzansky said.

The study was supported by the Robert Wood Johnson Foundation’s Pioneer Portfolio through the grant “Exploring Concepts of Positive Health.”

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