Perceived Level of Life Enjoyment and Risks of Cardiovascular Disease Incidence and Mortality

Shirai, Kokoro; Iso, Hiroyasu; Ohira, Tetsuya; Ikeda, Ai; Noda, Hiroyuki; Honjo, Kaori; Inoue, Manami; Tsugane, Shoichiro

doi:10.1161/circulationaha.108.834176

Cited by 78 publications

(69 citation statements)

References 42 publications

(43 reference statements)

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“…The prospective association between positive affect and CHD was not reliant on self-report measures of affect and remained robust after adjusting for age, sex and cardiovascular risk factors, including depression and hostility. These associations are corroborated by other longitudinal prospective studies that have controlled for important covariates and biological risk factors (Shirai et al, 2009;Tindle et al, 2009).…”

Section: Introductionsupporting

confidence: 75%

Positive emotional style and subjective, cardiovascular and cortisol responses to acute laboratory stress

Bostock

Hamer

Wawrzyniak

et al. 2011

Psychoneuroendocrinology

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Section: Introductionsupporting

confidence: 75%

Positive emotional style and subjective, cardiovascular and cortisol responses to acute laboratory stress

Bostock

Hamer

Wawrzyniak

et al. 2011

Psychoneuroendocrinology

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“…Similarly, in a study of nearly 8,000 British civil servants, greater life satisfaction was associated with a reduced risk of CHD after accounting for relevant risk factors (Boehm, Peterson, Kivimaki, & Kubzansky, 2011a). Another study of approximately 88,000 Japanese men and women replicated these results over a median of 12 years (Shirai et al, 2009). In men, low life enjoyment was associated with an increased risk of nonfatal CVD (HR ϭ 1.23, 95% CI [1.05, 1.44]), and mortality from CVD (HR ϭ 1.61, 95% CI [1.32, 1.96]).…”

Section: Ppwb and Cardiovascular Health Disease-related Endpointsmentioning

confidence: 77%

The heart's content: The association between positive psychological well-being and cardiovascular health.

Boehm

Kubzansky

2012

Psychological Bulletin

749

698

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This review investigates the association between positive psychological well-being (PPWB) and cardiovascular disease (CVD). We also consider the mechanisms by which PPWB may be linked with CVD, focusing on the health behaviors (e.g., smoking, alcohol consumption, physical activity, sleep quality and quantity, and food consumption) and biological functions (e.g., cardiovascular, inflammatory, and metabolic processes) that are most relevant for cardiovascular health. Because PPWB is a broad concept, not all aspects of PPWB may be associated with cardiovascular health. Thus, we distinguish between eudaimonic well-being, hedonic well-being, optimism, and other measures of well-being when reviewing the literature. Findings suggest that PPWB protects consistently against CVD, independently of traditional risk factors and ill-being. Specifically, optimism is most robustly associated with a reduced risk of cardiovascular events. In general, PPWB is also positively associated with restorative health behaviors and biological function and inversely associated with deteriorative health behaviors and biological function. Cardiovascular health is more consistently associated with optimism and hedonic well-being than with eudaimonic well-being, although this could be due in part to more limited evidence being available concerning eudaimonic well-being. Some similarities were also evident across different measures of PPWB, which is likely due to measurement overlap. A theoretical context for this research is provided, and suggestions for future research are given, including the need for additional prospective investigations and research that includes multiple constructs of psychological well-being and ill-being.Keywords: cardiovascular disease, health behaviors, biological function, eudaimonic well-being, hedonic well-being Scholars have long recognized the connection between mental health and physical health. From the ancient Roman poet Juvenal who declared, "A healthy mind in a healthy body," to early 20th century psychoanalysts who investigated the connection between mental states and physiology (Menninger & Menninger, 1936), and to researchers in the late 20th century seeking to identify disease-prone personalities (H. S. Friedman & Booth-Kewley, 1987;Rosenman et al., 1964), the complex relationship between psychological attributes and physical ailments has been the subject of fascination across time. Although past research has predominantly focused on the relationship between poor psychological functioning (e.g., anxiety, depression, hostility) and physical health, increasing research also suggests that a protective relationship exists between positive psychological functioning and physical health (Diener & Chan, 2011;Pressman & Cohen, 2005). Because the effects of psychological well-being and psychological ill-being are not merely opposites of one another and the absence of one does not necessarily indicate the presence of the other (Ryff et al., 2006;Ryff & Singer, 1998), it is critical to consider each separately in rel...

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“…Self-rated health has an established association with mortality (26), and is an integrated indicator of subjective physical and mental symptoms and health appraisals (27). However, in this sample, these factors accounted for only approximately 30% of the protective effect of PA. Other recent studies of mortality that used retrospective measures of wellbeing have demonstrated greater attenuation of effects when sociodemographic factors, health, and health behavior are taken into account (6,9,28).…”

Section: Discussionmentioning

confidence: 99%

“…There is evidence that positive affective states and other measures of well-being are associated prospectively with longer survival and reduced risk of diseases of older age (3)(4)(5)(6)(7)(8)(9). Effects are maintained after initial health status and established risk factors are taken into account, and may also be independent of negative states such as depression (3,10).…”

mentioning

confidence: 99%

“…To date, studies relating positive well-being with mortality have mainly relied on assessments of recollected emotional states, in which people are asked to rate their feelings of happiness or well-being in general, either without any time frame (5,6,9,11,12) or over a specific time period such as the previous 4 wk (4,8,10,13,14). Psychological research has established that recollected affect may diverge from actual experience because it is influenced by errors in recollection, recall biases, focusing illusions, and salient memory heuristics (15,16).…”

mentioning

confidence: 99%

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Positive affect measured using ecological momentary assessment and survival in older men and women

Steptoe

Wardle

2011

Proc. Natl. Acad. Sci. U.S.A.

151

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Links between positive affect (PA) and health have predominantly been investigated by using measures of recollected emotional states. Ecological momentary assessment is regarded as a more precise measure of experienced well-being. We analyzed data from the English Longitudinal Study of Aging, a representative cohort of older men and women living in England. PA was assessed by aggregating momentary assessments over a single day in 3,853 individuals aged 52 to 79 y who were followed up for an average of 5 y. Respondents in the lowest third of PA had a death rate of 7.3%, compared with 4.6% in the medium-PA group and 3.6% in the high-PA group. Cox proportional-hazards regression showed a hazard ratio of 0.498 (95% confidence interval, 0.345-0.721) in the high-PA compared with the low-PA group, adjusted for age and sex. This was attenuated to 0.646 (95% confidence interval, 0.436-0.958) after controlling for demographic factors, negative affect, depressed mood, health indicators, and health behaviors. Negative affect and depressed mood were not related to survival after adjustment for covariates. These findings indicate that experienced PA, even over a single day, has a graded relationship with survival that is not caused by baseline health status or other covariates. Momentary PA may be causally related to survival, or may be a marker of underlying biological, behavioral, or temperamental factors, although reverse causality cannot be conclusively ruled out. The results endorse the value of assessing experienced affect, and the importance of evaluating interventions that promote happiness in older populations.positive well-being | mortality | aging S ubjective well-being is being increasingly seen as an indicator of societal progress (1), and some countries are beginning to establish national well-being surveys (2). There is evidence that positive affective states and other measures of well-being are associated prospectively with longer survival and reduced risk of diseases of older age (3-9). Effects are maintained after initial health status and established risk factors are taken into account, and may also be independent of negative states such as depression (3, 10).To date, studies relating positive well-being with mortality have mainly relied on assessments of recollected emotional states, in which people are asked to rate their feelings of happiness or well-being in general, either without any time frame (5,6,9,11,12) or over a specific time period such as the previous 4 wk (4,8,10,13,14). Psychological research has established that recollected affect may diverge from actual experience because it is influenced by errors in recollection, recall biases, focusing illusions, and salient memory heuristics (15,16). This "memoryexperience gap" between life as it is remembered and life as it is experienced may be important to the processes through which the past impacts on future behavior (17).Methods of overcoming the limitations of retrospective measures include the use of ecological momentary assessment (EMA) (18), ...

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Perceived Level of Life Enjoyment and Risks of Cardiovascular Disease Incidence and Mortality

Abstract: A lower perceived level of life enjoyment was found to be associated with higher risks of cardiovascular disease incidence and mortality among middle-aged men, suggesting a protective role of positive psychological conditions on cardiovascular disease.

Cited by 78 publications

References 42 publications

Positive emotional style and subjective, cardiovascular and cortisol responses to acute laboratory stress

Positive emotional style and subjective, cardiovascular and cortisol responses to acute laboratory stress

The heart's content: The association between positive psychological well-being and cardiovascular health.

Positive affect measured using ecological momentary assessment and survival in older men and women

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