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Happiness may protect against heart disease

Feb. 21, 2010
Courtesy European Society of Cardiology
and World Science staff

Peo­ple who are usu­ally hap­py, en­thu­si­as­tic and con­tent are less likely than oth­ers to de­vel­op heart ill­ness, ac­cord­ing to a new stu­dy.

The scientists involved say the stu­dy, pub­lished in the Eu­ro­pe­an Heart Jour­nal, is the first to show an in­de­pend­ent rela­t­ion­ship be­tween pos­i­tive emo­tions and cor­o­nary heart dis­ease, the most com­mon type of heart di­sease. Pre­vi­ous stud­ies had linked hap­pi­ness with long life, but the ex­act rea­sons for that as­socia­t­ion are un­cer­tain.

Ka­rina Da­vid­son of Co­lum­bia Uni­vers­ity Med­i­cal Cen­ter in New York, who led the new stu­dy, said it sug­gests heart dis­ease might be in some de­gree pre­venta­ble through pos­i­tive emo­tions. But it would be prem­a­ture to make clin­i­cal rec­om­menda­t­ions with­out fur­ther stu­dy, she added.

“We des­pe­r­ately need rig­or­ous clin­i­cal tri­als in this ar­ea. If the tri­als sup­port our find­ings, then these re­sults will be in­credibly im­por­tant in de­scrib­ing spe­cif­ic­ally what clin­i­cians and/or pa­tients could do to im­prove health,” said Da­vid­son, who di­rects Co­lum­bi­a’s Cen­ter for Be­hav­ior­al Car­di­o­vas­cu­lar Health.

Over 10 years, Da­vid­son and col­leagues tracked 1,739 healthy adults, split about evenly be­tween men and wom­en, par­ti­ci­pat­ing in a study known as the 1995 No­va Sco­tia Health Sur­vey. At the start, trained nurses as­sessed the par­ti­ci­pants’ risk of heart dis­ease and, with both self-reporting and clin­i­cal as­sess­ment, they meas­ured symp­toms of de­pres­sion, hos­til­ity, anx­i­e­ty and the de­gree of ex­pres­sion of pos­i­tive emo­tions, which is known as “pos­i­tive af­fec­t.”

Pos­i­tive af­fect is de­fined as the ex­pe­ri­ence of pleas­ur­a­ble emo­tions such as joy, hap­pi­ness, ex­cite­ment, en­thu­si­asm and con­tentment. These feel­ings can be tran­sient, but they are usu­ally sta­ble and trait-like, par­tic­u­larly in adult­hood, ac­cord­ing to re­search­ers. Pos­i­tive af­fect is largely in­de­pend­ent of neg­a­tive af­fect, so that some­one who is gen­er­ally a hap­py, con­tented pe­r­son can al­so be oc­ca­sion­ally anx­ious, an­gry or de­pressed.

Af­ter tak­ing ac­count of age, sex, car­di­o­vas­cu­lar risk fac­tors and neg­a­tive emo­tions, the sci­en­tists found that in­creased pos­i­tive af­fect pre­dicted less risk of heart dis­ease by 22 per­cent per point on a five-point scale meas­ur­ing lev­els of pos­i­tive af­fect ex­pres­sion. “We al­so found that if some­one, who was usu­ally pos­i­tive, had some de­pres­sive symp­toms at the time of the sur­vey, this did not af­fect their over­all low­er risk of heart dis­ease,” Da­vid­son said. “As far as we know, this is the first pro­spec­tive study to ex­am­ine the rela­t­ion­ship be­tween clin­ic­ally-as­sessed pos­i­tive af­fect and heart dis­ease.”

“We have sev­er­al pos­si­ble ex­plana­t­ions” for the ef­fect, said Da­vid­son. “First, those with pos­i­tive af­fect may have long­er pe­riods of rest or re­laxa­t­ion phys­i­o­logic­al­ly,” mak­ing their bod­ies bet­ter able to reg­u­late blood pres­sure and heart rate. “Sec­ond, those with pos­i­tive af­fect may re­cov­er more quickly from stres­sors, and may not spend as much time ‘re-living’ them, which in turn seems to cause phys­i­o­log­ical dam­age. This is spec­u­la­tive, as we are just be­gin­ning to ex­plore why pos­i­tive emo­tions and hap­pi­ness have pos­i­tive health ben­e­fits.”


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People who are usually happy, enthusiastic and content are less likely to develop heart disease than those who tend not to be happy, according to a major new study. The researchers believe that the study, published in the European Heart Journal, is the first to show such an independent relationship between positive emotions and coronary heart disease. Previous studies had linked happiness with long life, but the exact reasons for that association are uncertain. Karina Davidson of Columbia University Medical Center in New York, who led the new study, said it suggests heart disease might be in some degree preventable through positive emotions. But it would be premature to make clinical recommendations without further study, she added. “We desperately need rigorous clinical trials in this area. If the trials support our findings, then these results will be incredibly important in describing specifically what clinicians and/or patients could do to improve health,” said Davidson, who directs Columbia’s Center for Behavioral Cardiovascular Health. Over 10 years, Davidson and colleagues tracked 1,739 healthy adults, split about evenly between men and women, participating in a study known as the 1995 Nova Scotia Health Survey. At the start, trained nurses assessed the participants’ risk of heart disease and, with both self-reporting and clinical assessment, they measured symptoms of depression, hostility, anxiety and the degree of expression of positive emotions, which is known as “positive affect.” Positive affect is defined as the experience of pleasurable emotions such as joy, happiness, excitement, enthusiasm and contentment. These feelings can be transient, but they are usually stable and trait-like, particularly in adulthood, according to researchers. Positive affect is largely independent of negative affect, so that someone who is generally a happy, contented person can also be occasionally anxious, angry or depressed. After taking account of age, sex, cardiovascular risk factors and negative emotions, the scientists found that increased positive affect predicted less risk of heart disease by 22% per point on a five-point scale measuring levels of positive affect expression. “We also found that if someone, who was usually positive, had some depressive symptoms at the time of the survey, this did not affect their overall lower risk of heart disease,” Davidson said. “As far as we know, this is the first prospective study to examine the relationship between clinically-assessed positive affect and heart disease.” “We have several possible explanations” for the effect, said Davidson. “First, those with positive affect may have longer periods of rest or relaxation physiologically,” making their bodies better able to regulate blood pressure and heart rate. “Second, those with positive affect may recover more quickly from stressors, and may not spend as much time ‘re-living’ them, which in turn seems to cause physiological damage. This is speculative, as we are just beginning to explore why positive emotions and happiness have positive health benefits.”