Longitudinal associations between positive psychological factors and cardiovascular health

Abstract

Background The health promoting effects of positive psychological factors in cardiovascular disease (CVD) are gaining increasing attention. Key factors such as optimism, mindfulness, positive affect, and life satisfaction have been linked to a lower incidence of CVD. While these effects are often explained by favorable health behaviors, potential biological mechanisms are insufficiently explored. Objectives We aimed to to investigate independent associations between positive psychological factors and prospective changes in intermediate biological coronary heart disease (CHD) risk factors in CHD-patients, hypertensives (HT), and normotensive controls (NT). Methods At baseline, 200 men (CHD=86,HT = 61,NT = 53) completed questionnaires on positive psychological factors and had blood samples collected. As CHD-risk factors lipid profiles (TC/HDL-ratio), blood glucose (HbA1c), coagulation (fibrinogen, D-dimer), and inflammation markers (CRP, IL-6, TNF-α) were measured. At 3-year follow-up, blood sample were collected from 126 men (NT = 34,HT = 37,CHD=55). Results At baseline, the groups differed in positive affect only [F(2,197) = 3.63, p = .028], with highest levels in NT and lowest levels in CHD. Prospectively, higher baseline positive affect (p = .026) and life satisfaction (p = .026) were associated with lower CHD-risk over time. Specifically, higher baseline positive affect predicted lower increase in coagulation markers (p = .010), particularly fibrinogen (ß=-0.37, p = .003), while higher baseline life satisfaction predicted lower increase in inflammation markers, especially IL-6 (ß=-.38, p = .005). Neither optimism nor mindfulness were linked to change in CHD-risk factors over time. Conclusion Positive affect and life-satisfaction may benefit cardiovascular health by favorably affecting coagulation and inflammation, with potential implications for CHD prevention and intervention strategies.