Heart disease, including conditions like coronary artery disease, heart attacks, and heart failure, has been the top killer globally for years now. The staggering statistic that over seventeen million people lose their lives to heart disease every single year shows the immense and tragic impact cardiovascular disease has.
Heart disease robs people of precious time with their families. The lost potential and productivity for society is also enormous when people pass away from heart disease in the prime of life.
Given the immense burden heart disease places on humanity, promoting heart health encompasses both preventing heart disease through controlling risk factors like high blood pressure, diabetes, smoking, and high cholesterol, as well as optimizing treatment for heart disease. Even small improvements in heart health rates could save many lives.
We know diet and physical activity affect the risk of developing cardiovascular disease but what about your outlook on life? An emerging body of research suggests that cultivating positive psychological traits like optimism, life satisfaction, and purpose may protect cardiovascular health. What does science say?
The Link Between Positive Psychology and Heart Disease
Multiple studies have found optimistic individuals have a lower risk of developing cardiovascular disease (CVD) and are less likely to die from heart-related causes. According to one study, over an 8-year follow-up, women in the highest quartile for optimism had a 38-39% lower risk of fatal heart disease and stroke compared to those with the lowest optimism.
This relationship held even after accounting for related factors like socioeconomic status, health behaviors, and negative psychological traits. In a meta-analysis of fifteen studies with over 229,000 participants, higher optimism was associated with a 35% lower risk of future cardiovascular events after adjustment for potential confounders.
Research links other facets of well-being like life satisfaction, positive emotions, sense of purpose, and self-efficacy to favorable cardiovascular outcomes. Combined, this evidence indicates positive psychological traits may offer unique protective effects against heart disease, beyond their association with lifestyle behaviors.
Plausible Biological Mechanisms Behind Optimism for Heart Health
Researchers have proposed several pathways that could mediate the observed relationship between positive well-being and cardiovascular health:
- Health behaviors: Optimistic individuals may be more likely to engage in heart-healthy behaviors like exercising, eating well, and not smoking. However, statistical adjustment for health behaviors does not fully account for the association, suggesting other factors contribute too.
- Physiological functioning: Positive traits correlate with beneficial biological markers like lower blood pressure, cholesterol levels, and inflammatory markers.
- Nervous system function: Well-being may also promote adaptive regulation of the autonomic nervous system based on findings linking optimism and positive emotions to greater heart rate variability. (a marker of cardiovascular health)
- Resilience: Optimism enhances resilience by boosting confidence in one’s ability to manage challenges. This facilitates effective coping strategies and perseverance during challenging times rather than helplessness. Building resilience helps safeguard cardiovascular health against life’s inevitable stressors.
Taken together, cultivating positive psychological traits may impart cumulative physiological benefits that promote cardiovascular resilience over the lifespan.
Can Changing Our Outlook Lower Our Risk of Cardiovascular Disease?
If well-being helps protect your heart, an important next question is whether you can actively increase optimism and positive functioning through targeted interventions. In a meta-analysis of thirty-nine randomized trials, positive psychology interventions increased well-being and reduced depressive symptoms compared to control groups. Most studies have looked at simple activities like writing gratitude letters, envisioning your best self, practicing acts of kindness, and meditating on positive experiences.
Research specifically examining the cardiovascular effects of increasing optimism remains limited but shows early promise. For example, one trial found that 2 months of group sessions teaching optimism skills lowered ambulatory blood pressure and acute cardiovascular reactivity to stress in high-risk youth compared to controls.
Future Research Directions
While current evidence suggests positive psychological traits may benefit heart health, we need more research to strengthen our understanding of these relationships and how to leverage them to improve our own cardiovascular health. Key areas for additional investigation include:
- Identifying which facets of well-being offer the greatest cardiovascular benefits and are most modifiable through interventions.
- Discovering how positive traits like optimism exert protective physiological effects by linking them to underlying biological mediators.
- Exploring potential synergies with existing lifestyle and pharmacological strategies to determine the optimal combined approach to promoting heart health.
Conclusion
An extensive body of observational data links higher optimism, life satisfaction, sense of purpose, and other markers of well-being to reduced cardiovascular risk. Early interventional studies also indicate we can increase positive functioning through simple self-guided activities. This raises the intriguing possibility that integrating positive psychology approaches into a heart healthy lifestyle could help better manage heart health. Evidence to date suggests that by cultivating positivity, we may also reap cardiovascular benefits – giving us one more reason to look on the bright side!
References
- Boehm, JK, et al. A prospective study of positive psychological well-being and coronary heart disease. Health Psychol. 2011;30(3):259-267.
- Kim ES, et al. Optimism and Cause-Specific Mortality: A Prospective Cohort Study. Am J Epidemiol. 2017;185(1):21‐29.
- Hernandez R, Kershaw KN, Siddique J, Boehm JK, Kubzansky LD, Diez-Roux A, Ning H, Lloyd-Jones DM. Optimism and Cardiovascular Health: Multi-Ethnic Study of Atherosclerosis (MESA). Health Behav Policy Rev. 2015 Jan;2(1):62-73. doi: 10.14485/HBPR.2.1.6. PMID: 26213688; PMCID: PMC4509598.
- Tindle HA, Chang YF, Kuller LH, et al. Optimism, Cynical Hostility, and Incident Coronary Heart Disease and Mortality in the Women’s Health Initiative. Circulation. 2009;120(8):656-662. doi:https://doi.org/10.1161/circulationaha.108.827642
- Kubzansky LD, Huffman JC, Boehm JK, Hernandez R, Kim ES, Koga HK, Feig EH, Lloyd-Jones DM, Seligman MEP, Labarthe DR. Positive Psychological Well-Being, and Cardiovascular Disease: JACC Health Promotion Series. J Am Coll Cardiol. 2018 Sep 18;72(12):1382-1396. doi: 10.1016/j.jacc.2018.07.042. PMID: 30213332; PMCID: PMC6289282.
- Boehm JK, et al. Is Optimism Associated with Healthier Cardiovascular-Related Behavior? Meta-Analyses of 3 Health Behaviors. Circ Res. 2018;122(8):1119‐1134.
- Boehm JK, Kubzansky LD. The heart’s content: the association between positive psychological well-being and cardiovascular health. Psychol Bull. 2012;138(4):655‐691.
- Bolier L, Haverman M, Westerhof GJ, Heleen Riper, Smit F, Bohlmeijer ET. Positive psychology interventions: a meta-analysis of randomized controlled studies. BMC Public Health. 2013;13(1). doi:https://doi.org/10.1186/1471-2458-13-119
- Rozanski A, Bavishi C, Kubzansky LD, Cohen R. Association of Optimism with Cardiovascular Events and All-Cause Mortality: A Systematic Review and Meta-analysis. JAMA Netw Open. 2019 Sep 4;2(9): e1912200. doi: 10.1001/jamanetworkopen.2019.12200. PMID: 31560385; PMCID: PMC6777240.
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