Be Happy, Be Healthy, Suggests Harvard Review
April 18, 2012

Be Happy, Be Healthy, Suggests Harvard Review

It has been long known that people who are chronically angry, anxious or depressed have a higher risk of heart attacks, so it only makes sense that those who are happy, upbeat and have a positive outlook on life have a decreased risk of heart problems, and that´s just what US experts have found in a new study.

A Harvard review of more than 200 studies, reported in the online journal Psychological Bulletin, suggests that people who are high on life have a lower risk of developing heart disease or a serious stroke.

And while these people are generally healthier, scientists believe a sense of well-being may lower risk factors such as high blood pressure and cholesterol as well.

Researchers from the Harvard School of Public Health (HSPH) in Boston poured over data from the multitude of research studies searching for associations between psychological well-being and cardiovascular health.

“The absence of the negative is not the same thing as the presence of the positive,” said Julia Boehm, researcher in the Department of Society, Human Development, and Health at HSPH said, and one of the lead authors of the study. “We found that factors such as optimism, life satisfaction, and happiness are associated with reduced risk of cardiovascular disease regardless of such factors as a person's age, socioeconomic status, smoking status, or body weight.”

“For example, the most optimistic individuals had an approximately 50 per cent reduced risk of experiencing an initial cardiovascular event compared to their less optimistic peers,” she explained.

Each of the 200 studies used questionnaires and assessments to score individuals´ characteristics and outlooks, and measured the extent to which individuals consider themselves a happy or unhappy person, satisfaction with their life and the extent to which they experience pleasurable feelings. Some of the research papers also looked at optimism and hope, the extent to which individuals have expectancies for positive outcomes in the future and enthusiasm for life.

Senior author of the Harvard review, associate professor Laura Kubzansky, said there are psychological assets, like optimism and positive emotion, that afford protection against cardiovascular disease.

The research showed that people with a positive outlook on life and who were more optimistic about the future tended to lead healthier lives overall, including exercising more, eating better, and getting enough sleep.

Boehm and colleagues stressed, however, that their work only suggested a link and is not proof that well-being protects against heart disease. And not only is it difficult to objectively measure well-being, other heart risk factors like cholesterol and diabetes are more important when it comes to reducing disease.

Although the researchers looked at 200 studies, they said this number is still not enough to draw a firm conclusion and added more research is needed.

Most previous studies involving mood and heart disease focused more on stress and anxiety rather than happiness.

“The association between heart disease and mental health is very complex and still not fully understood,” Maureen Talbot, senior cardiac nurse at the British Heart Foundation, told BBC News. “Although this study didn´t look at the effects of stress, it does confirm what we already know which is psychological well-being 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,” Talbot added.

It is generally believed that a positive attitude to life makes people more resilient to stress and other life-changing events, according to the researchers.

In one of the studies the team examined, involving 300 men and women having bypass surgery, those with a positive outlook were 50 percent less likely to be admitted to the hospital for heart problems or complications six months out from the surgery.

Kubzansky said that if future research confirms that positive attitudes, happiness and overall satisfaction with life do in fact lead to better cardiovascular health, it would have strong implications for the design of prevention and treatment of heart disease and stroke.

“These findings suggest that an emphasis on bolstering psychological strengths rather than simply mitigating psychological deficits may improve cardiovascular health,” she said.

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

The Harvard review was funded by the Robert Wood Johnson Foundation.

While more research is needed, the link between psychological and physical well-being makes sense, said Dr. Elizabeth Jackson of the University of Michigan and American College of Cardiology.

Jackson, who wasn´t involved with the Harvard review, told The Telegraph that among her own patients, she has noticed that those who feel they have some control over their lives and invested in their care have better outcomes.

Boehm, citing another research, said just asking people to smile can put them in a better mood, although long-term effects aren´t clear.

“Sometimes it´s hard, particularly in tough economic times, but taking a moment to just relax and enjoy a sunny day might be good heart health,” Jackson said.