Community-Based Evaluation of the Associations Between Well-Being and Cardiovascular Disease Risk

Abstract

BACKGROUND: Although the effects of psychological health and optimism have been extensively investigated, data from community-based cohorts assessing the association between psychological health and cardiovascular disease risk factors are sparse, and the concurrent relationship between subjective well-being and cardiovascular health has not been studied. METHODS AND RESULTS: The current cross-sectional study examined the association between well-being and cardiovascular risk factors among 719 individuals living in a middle-to low-income neighborhood. After adjusting for age, sex, race, body mass index, education, smoking status, and exercise status, we found that higher levels of well-being were significantly associated with lower odds of dyslipidemia (odds ratio [OR], 0.7 [95% CI, 0.55–0.85]) and hypertension (OR, 0.8 [95% CI, 0.63– 0.92]). Greater well-being was also significantly associated with lower triglyceride levels (mean difference [Mdiff ], 7.6 [−14.31 to −0.78]), very low-density lipoprotein (Mdiff, 0.9 [−1.71 to −0.16]), total cholesterol to high-density lipoprotein ratio (Mdiff, 3.9 [−6.07 to −1.73]), higher high-density lipoprotein levels (Mdiff, 1.6 [0.46–2.75]), and lower Framingham Risk Scores (Mdiff, −7.1% [−10.84% to −3.16%]). Well-being also moderated the association between age and arterial stiffness. The strongest association between arterial stiffness and age was found for those with the lowest well-being scores; there was no association between age and arterial stiffness at high levels of well-being. CONCLUSIONS: In a community-based cohort, individuals reporting higher levels of well-being have lower odds of hypertension and dyslipidemia as well as lower rates of age-dependent increase in vascular stiffness. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03670524.