Positive Psychological Well-Being and Cardiovascular Disease

Abstract

Various forms of psychological distress, including depression and anxiety, are known to increase risk for cardiovascular disease (CVD). However, most people are not actively distressed; rather, they experience varying levels of positive psychological well-being (PPWB), which includes such constructs as life satisfaction, positive emotions, optimism, and vitality. Up until relatively recently, the role of PPWB in cardiovascular disease (CVD) has not garnered as much attention as the role of psychological distress. This chapter assesses the current state of knowledge on the topic by reviewing the evidence for an association between facets of PPWB and CVD, with a particular focus on whether the association exists above and beyond known associations with psychological distress. To this end, we identified prospective longitudinal studies of both healthy and patient populations that measured initial levels of PPWB and development of an objective CVD-related endpoint after some period of follow-up. Results suggest that in healthy populations, PPWB and CVD are reliably related such that enhanced PPWB is associated with reduced risk of incident CVD and mortality. In patient populations, the relationship is somewhat less consistent but still points to a potentially protective relationship between higher levels of PPWB and subsequent progression of CVD. This review also highlights important considerations for future research including isolating the critical aspect of PPWB related to CVD health, identifying modifiers of the relationship (including gender, ethnicity, and disease severity), and exploring possible mechanisms (including health behaviors and biological markers). To conclude, we discuss implications of our findings for CVD prevention and intervention.