Happy with your life? Research links contentment with fewer heart attacks and strokes

People who are content with their lives or feel a sense of well-being may be less likely to develop heart disease and/or stroke compared to those with a lower sense of well-being, according to a new analysis published today (Sept. 18) in the Journal of the American Heart Association.

“Our findings support a holistic approach to health care, where enhancing a person’s mental and emotional well-being is considered an integral part of preventing heart disease and stroke,” said senior author Wen Sun, M.D., Ph.D., associate director of the Stroke Center at the University of Science and Technology of China in Hefei, China.

“Health care professionals might consider including strategies to improve life satisfaction and happiness as part of routine care, such as recommending regular physical activities, social activities or stress management techniques as effective ways to enhance personal well-being.”

It is well-known that life satisfaction, or well-being, can increase mental health. However, the influence of well-being on cardiovascular health is less clear, the study authors wrote.

After reviewing questionnaires of more than 120,000 participants in the UK Biobank database, investigators assessed well-being as it related to satisfaction with family, friendships, health, finances and general happiness. Researchers analyzed the potential connection of well-being with the development of four major cardiovascular diseases: coronary heart disease, heart attack, heart failure and stroke.

The study also examined the impact of well-being on lifestyle factors and inflammatory markers. An additional analysis, a Mendelian randomization, used genetic variations to address potential cause-and-effect questions about how modifiable risk factors may have influenced different outcomes.

The analysis found:

• Compared to adults with a low sense of well-being, the overall risk of developing cardiovascular disease was 10% to 21% lower for people with the highest well-being scores.
• Specifically, compared to adults with a low sense of well-being, people with the highest well-being scores had a 44% lower risk of coronary artery disease, 45% lower risk of stroke, a 51% lower risk of heart failure and a 56% lower risk of heart attack.
• A two-step Mendelian randomization analysis suggested that people with higher levels of well-being tended to adopt healthier lifestyles and had lower inflammatory markers. Researchers said this supports a potential cause-and-effect relationship between higher well-being and reduced cardiovascular risk.

“These results underscore the profound impact that emotional and psychological health can have on physical well-being, shedding light on intricate biological mechanisms that were not fully appreciated before,” Sun said.

A 2021 American Heart Association scientific statement, Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association, notes that psychological health can positively or negatively impact a person’s health and risk factors for heart disease and stroke.

Glenn N. Levine, M.D., a professor of medicine at Baylor College of Medicine and chair of the scientific statement, said, “While these findings are not unexpected, they add to the growing body of data that psychological health can impact cardiovascular risk.

“Much of the focus on psychological health has understandably been on negative factors such as depression and stress. This study emphasizes the importance of positive psychological health, including the more global factor of a person’s sense of well-being,” said Levine, who was not involved in the study.

Although the current study found a strong connection, there were several limitations. First, questionnaires do not always yield precise information, since people may forget or answer incorrectly. Second, the study did not have information about how blood markers of inflammation may have changed over time.

Finally, study participants were primarily white adults who were relatively affluent (characterized by living in less economically deprived areas, with a higher likelihood of owning property and a lower likelihood of having mortgages, shared ownership or living in rental accommodations). In addition, all participants lived in the United Kingdom, so these findings may not apply to people living in other countries.

Study details and background:

• The data reviewed was from the UK Biobank, which recruited study participants from health centers throughout the United Kingdom from 2006 to 2010.
• Participants in this analysis included 121,317 adults without heart disease when they enrolled. Their average age was 57 years old, and 45% were men.
• Over a median follow-up period of nearly 12 years, ending in October 2022, health records indicate there were 3,323 heart failure cases, 5,990 strokes, 6,462 heart attacks, and 9,177 coronary heart disease cases.
• Researchers reviewed patient questionnaires, blood tests, electronic health records and hospital procedure codes through October 31, 2022.
• In a patient survey on well-being taken at enrollment, participants rated their general happiness and satisfaction with family, friendships, health, finances and job as “Extremely happy,” “Very happy,” “Moderately happy,” “Moderately unhappy,” “Very unhappy” or “Extremely unhappy.”

Sun said future research will build on these current findings and “explore how psychological well-being might influence cardiovascular health as well as other health conditions. This line of investigation is crucial for developing a holistic understanding of how mental well-being influences overall health.”