High levels of optimism may lead to a better diet, regular exercise and lower stress.
September 10, 2018, Chicago, IL—Maintaining positive thoughts and feelings through intervention programs can help patients achieve better overall outcomes when it comes to their cardiovascular health, according to a review paper published today in the Journal of the American College of Cardiology. This paper is part of an eight-part health promotion series where each paper will focus on a different risk factor for cardiovascular disease.
“We addressed how social environment, psychological well-being and
the effectiveness of intervention strategies can help strengthen a
patient’s outlook,” said Darwin R. Labarthe, MD, MPH, PhD, professor of
Preventive Medicine at Northwestern University Feinberg School of
Medicine and the review’s lead author. “We focused on whether
psychological well-being can be consistently related with a reduced risk
of heart disease.”
The review defines cardiovascular health in two parts: health
behaviors (healthy diet, physical activity, smoking status and body mass
index) and health factors (favorable blood pressure, total cholesterol
In this review, the authors looked at a growing body of research to
examine whether psychological well-being might lead to reduced risk of
heart disease. Prospective studies have shown a positive relationship
between optimism (one facet of psychological well-being) and heart
disease, including a 2017 study showing older women in the highest
quartile of optimism had a 38 percent reduced risk of heart disease
mortality. Additional studies since 2012 have associated a perceived
higher purpose in life with lower odds of having a stroke.
In the four health behavior components, the most optimistic patients
were less likely to be current smokers 12 months later, and high levels
of psychological well-being were associated with regular physical
activity. Optimistic patients sustained healthier diets by consuming
more fruits and vegetables, and less processed meats and sweets, leading
patients to maintain a healthy BMI.
The review authors found that psychological well-being influenced
heart health through biological processes, health behaviors and
“Optimists persevere by using problem-solving and planning strategies
to manage stressors,” Labarthe said. “If others are faced with factors
out of their control, they begin to shift their goals and use
potentially maladaptive coping strategies, which would ultimately result
in raising inflammation levels and less favorable overall heart
Having a strong network of social support also gives patients
confidence about their future health and helps them act readily on
medical advice, engage in problem solving and take active preventive
measures. A likely link is that favorable social environment, known to
influence heart disease risk, has also been shown to predict
The authors said intervention programs may strengthen psychological
well-being. Mindfulness programs have been shown to improve anxiety,
quality of life, smoking cessation, healthy eating and more. Yoga and
tai chi, often incorporated in mindfulness-based interventions, have
improved outcomes in heart failure patients and lowered blood pressure.
Life purpose programs for palliative care patients have led to
improvements in mental health, distress from physical symptoms and
“It may seem challenging to help patients modify psychological well-being in the face of a new medical diagnosis, but these events can represent a ‘teachable moment.'” Labarthe said. “Just having patient-centered discussions surrounding sources of psychological well-being and information about specific activities to promote well-being are a small, but meaningful, part of a patient’s care.”
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