A Prospective Study of Positive Psychological Well-Being and Coronary Heart Disease

• Published in: Health psychology 2011-05, Vol.30 (3), p.259-267
• Main Authors: Boehm, Julia K, Peterson, Christopher, Kivimaki, Mika, Kubzansky, Laura
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular diseases; Cardiovascular Disorders; Confidence Intervals; Coronary Disease - psychology; Coronary diseases; Coronary heart disease; elderly; Emotions; Female; Fundamental and applied biological sciences. Psychology; Gender; Health; Heart; Heart diseases; Heart Disorders; Human; Humans; Illness and personality; Illness, stress and coping; intervention; Male; Medical sciences; Mental Health; Middle Aged; myocardial infarction; Optimism; Proportional Hazards Models; Prospective Studies; Psychological wellbeing; Psychology; Psychology and medicine; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Regression Analysis; Risk; Risk Factors; risk reduction; Socioeconomic Factors; Well Being; Wellbeing
• ISSN: 0278-6133; 1930-7810
• DOI: 10.1037/a0023124

Objective: Research suggests that positive psychological well-being is associated with cardiovascular health. However, much of this research uses elderly samples and has not determined the pathways by which psychological well-being influences cardiovascular disease or whether effects are similar for men and women. This study investigates the association between two aspects of well-being (emotional vitality and optimism) and coronary heart disease (CHD) in a sample of middle-aged men and women, and considers potential mediating factors. Method: Between 1991 and 1994, well-being and coronary risk factors were assessed among 7,942 individuals without a prior cardiovascular event from the Whitehall II cohort. Incident CHD (fatal CHD, first nonfatal myocardial infarction, or first definite angina) was tracked during 5 person-years of follow-up. Results: Positive psychological well-being was associated with reduced risk of CHD with an apparent threshold effect. Relative to people with the lowest levels of well-being, those with the highest levels had minimally adjusted hazard ratios of 0.74, 95% confidence interval [0.55, 0.98] for emotional vitality and 0.73, 95% confidence interval [0.54, 0.99] for optimism. Moreover, the association was strong for both genders and was only weakly attenuated when accounting for ill-being. Neither health-related behaviors nor biological factors explained these associations. Conclusions: Positive psychological well-being was associated with a modest, but consistent reduced risk of incident CHD. The relationship was comparable for men and women, and was maintained after controlling for cardiovascular risk factors and ill-being. Additional research is needed to identify underlying mechanisms and investigate whether interventions to increase well-being may enhance cardiovascular health.