Does life satisfaction reduce risk of incident hypertension and stroke? Evidence from the Whitehall II cohort

• Published in: Journal of psychosomatic research 2021-05, Vol.144, p.110414-110414, Article 110414
• Main Authors: Guimond, Anne-Josée, Kubzansky, Laura D., Boehm, Julia K., Kivimaki, Mika, Trudel-Fitzgerald, Claudia
• Format: Article
• Language: English
• Subjects: Adult; Associations; Blood pressure; Cardiovascular disease; Cardiovascular diseases; Coronary artery disease; Diabetes; Diabetes mellitus; Drugs; Female; Government employees; Health behavior; Health status; Heart diseases; Humans; Hypertension; Hypertension - epidemiology; Hypertension - psychology; Incidence; Ischemia; Life satisfaction; Longitudinal studies; Male; Medical diagnosis; Mental health; Middle age; Middle Aged; Personal Satisfaction; Physicians; Positive psychology; Prospective Studies; Psychological distress; Regression analysis; Risk Assessment; Risk factors; Risk reduction; Sociodemographics; Stroke; Stroke - epidemiology; Stroke - psychology; Transient ischemic attack; United Kingdom - epidemiology; Well-being
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2021.110414

Previous studies showed life satisfaction is related to reduced risk of coronary heart disease and diabetes, but its association with other cardiometabolic endpoints including hypertension and stroke remains unexplored. This study examined life satisfaction's prospective association with incident hypertension and stroke in middle-aged adults. At baseline (1985–1988), 6225 healthy British civil servants aged 35–55 from the Whitehall II cohort completed the validated Satisfaction with Life Scale and provided information regarding sociodemographics, a range of health-related factors, and psychological distress. Incident hypertension was ascertained according to clinic-derived measures of systolic or diastolic blood pressure of ≥140/90 mmHg, respectively, or self-reports of either physician-diagnosed hypertension or hypertensive medication use. Incident stroke and transient ischemic attack (TIA) were ascertained by self-reported physician diagnosis. Follow-up assessments occurred every 2–5 years through 2017. Cox proportional hazards regression models estimated hazard ratios (HR) and 95% confidence intervals (CI) of hypertension and stroke/TIA risk separately. Over a 31-year follow-up, 2703 cases of hypertension and 370 cases of stroke/TIA occurred. Life satisfaction was not related to risk of developing hypertension but was associated with 12% decreased risk of stroke/TIA after controlling for sociodemographics, health status, and health behaviors (HRper 1-SD = 0.88; 95%CI = 0.79–0.98). However, the association was attenuated after adjustment for psychological distress. No robust associations were found between life satisfaction and incident hypertension and stroke/TIA, respectively, after accounting for well-established risk factors and psychological distress. More research is needed to understand why associations of life satisfaction with cardiometabolic health seem to vary across endpoints. •Life satisfaction was not related to hypertension risk.•Life satisfaction was associated with 12% decreased risk of stroke.•The observed association was attenuated after accounting for psychological distress.