Optimism could benefit the heart: A review of studies

By Dr. Ananya Mandal, MDApr 19 2012

A Harvard School of Public Health review of more than 200 studies suggests that optimism is good for the heart. The researchers looked at studies that had recorded psychological well-being and cardiovascular health. This revealed that factors such as optimism, life satisfaction, and happiness appeared to be linked associated with a reduced risk of heart and circulatory diseases, regardless of a person's age, socio-economic status, smoking status or body weight. Disease risk was 50% lower among the most optimistic individuals.

The study was funded by the Robert Wood Johnson Foundation though an “Exploring the Concept of Positive Health” grant. It appears in the April 17 issue of the American Psychological Association journal Psychological Bulletin.

“Historically, studies have focused on the negative impact of depression and anxiety,” Julia Boehm who led the review said. “We wanted to look at the flip side to see how psychological well-being -- things like happiness, optimism, and having a sense of purpose -- might impact [heart disease and stroke] risk.”

Along with Harvard associate professor Laura D. Kubzansky, Boehm showed that happiness and optimism tended to predict better heart health. People who reported having a greater sense of well-being were also more likely to have healthier lifestyles, which could explain their better outcomes, Boehm said. They generally exercised more, ate better, and got more sleep than people who reported having a more negative view of life, and they were less likely to have risk factors for heart disease and stroke, such as high blood pressure, high cholesterol, and obesity. “This suggests that bolstering psychological strengths like happiness and optimism could improve cardiovascular health,” Boehm said.

Bryan Bruno, who is acting chairman of the department of psychiatry at Lenox Hill Hospital in New York City, said the negative impact of depression on heart attack and stroke risk is well established. “Most cardiologists are aware of the importance of treating depression in patients with heart disease,” he told WebMD. “Study after study has shown that once someone has had a cardiovascular event, their prognosis is a lot worse if they have untreated depression.”

Bruno said that while genes certainly play a role in disposition, behavioural therapy and other psychiatric interventions can help people improve their sense of well-being. “Helping people become more optimistic is often a goal of therapy,” he said.

More research is needed but that link between psychological and physical well-being makes sense, said Dr. Elizabeth Jackson of the University of Michigan and American College of Cardiology, who wasn't involved with the review. Among her own heart patients, she has noticed that those who feel they have some control over their lives and are invested in their care have better outcomes.

Prof Kubzansky said if future research continued to indicate that higher levels of satisfaction, optimism, and happiness proceeded good cardiovascular health, it would have strong implications for the design of prevention and treatment of heart disease and stroke.

The authors wrote in the paper, “Positive psychological wellbeing may influence cardiovascular health not only by buffering the effects of stress or reducing deteriorative behaviours and biology but also by directly enhancing behavioural and biological functioning. Thus, individuals with high levels of positive psychological wellbeing may have more opportunities for processes that promote rest, restoration, and the capacity to regenerate.”

Maureen Talbot, Senior Cardiac Nurse at the British Heart Foundation, said, “The association between heart disease and mental health is very complex and still not fully understood. Although this study didn’t look at the effects of stress, it does confirm what we already know which is that psychological wellbeing is an important part of a healthy lifestyle, just like staying active and eating healthily. It also highlights the need for healthcare professionals to provide a holistic approach to care, taking into account the state of someone’s mental health and monitoring its effect on their physical health.”