The growing role of psychological well-being in managing heart disease

Individuals who seek to improve and maintain their mental well-being with a combination of physical and psychosocial factors like mindfulness, yoga and life purpose programs can expect better heart health down the line, according to a meta-analysis published in the Journal of the American College of Cardiology.

The review, just one installment in an eight-part JACC health promotion series, focused on the relationship between cardiovascular health and psychological well-being in two halves. Since the link between poor mental health and adverse CVD outcomes is already strong, the reviewers honed in on individual aspects of both health behaviors, like diet, activity and BMI, and health factors, like blood pressure and glucose intake.

“Associations between adverse psychological factors, such as depression and CVD, are well-established,” first author Laura D. Kubzansky, PhD, and colleagues wrote in the journal. “However, accumulating evidence suggests that positive psychological well-being—which includes positive thoughts and feelings such as purpose in life, optimism and happiness—has its own independent associations with lower risk of CVD and may promote cardiovascular health.”

In their review, Kubzansky et al. found that when it came to health behaviors, the most optimistic patients were more likely to exercise regularly, stick to healthier diets and have lower BMIs. 

Those stats are already widely accepted as true, the authors said, but evidence surrounding psychosocial factors is more sparse.

“It is increasingly clear that effects of psychological well-being and distress are not simply two sides of the same coin,” the authors wrote. They found a strong social network alone could promote better heart health, since patients were more likely to seek support, act on medical advice and take preventive measures when their friends held them accountable.

Kubzansky and co-authors said social support from loved ones gives CVD patients more confidence in the management of their illness. Intervention programs or life purpose programs for palliative care patients have also been successful.

“Individual-level interventions, such as mindfulness-based programs and positive psychological interventions, have shown promise for modifying psychological well-being,” the authors wrote. “Further, workplaces are using well-being-focused interventions to promote cardiovascular health, and these interventions represent a potential model for expanding psychological well-being programs to communities and societies.”

The reviewers said further research is needed to solidify their findings and understand the mechanisms behind the connection between mental well-being and cardiovascular health.