Relationships between positive psychological constructs and health outcomes in patients with cardiovascular disease: A systematic review
Open accessAbstract
Depression and anxiety are well-known to be associated with adverse health outcomes in cardiac patients. However, there has been less work synthesizing the effects of positive psychological constructs (e.g., optimism) on health-related outcomes in cardiac patients. We completed a systematic review of prospective observational studies using established guidelines. A search of PubMed and PsycINFO databases from inception to January 2014 was used to identify articles. To be eligible, studies were required to assess effects of a positive psychological construct on subsequent health-related outcomes (including mortality, rehospitalizations, self-reported health status) in patients with established heart disease. Exploratory random effects' meta-analyses were performed on the subset of studies examining mortality or rehospitalizations. Seventy-seven analyses from 30 eligible studies (N=14,624) were identified. Among studies with 100 or more participants, 65.0% of all analyses and 64.7% of analyses adjusting for one or more covariates reported a significant (p<.05) association between positive psychological constructs and subsequent health outcomes. An exploratory meta-analysis of 11 studies showed that positive constructs were associated with reduced rates of rehospitalization or mortality in unadjusted (odds ratio=.87; 95% confidence interval [.83, .92]; p<.001) and adjusted analyses (odds ratio=.89; 95% confidence interval [.84, .91]; p<.001); there was little suggestion of publication bias. Among cardiac patients, positive psychological constructs appear to be prospectively associated with health outcomes in most but not all studies. Additional work is needed to identify which constructs are most important to cardiac health, and whether interventions can cultivate positive attributes and improve clinical outcomes.
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Cardiovascular researchers have identified that optimism, positive psychological constructs, and subjective well-being are linked to significantly better cardiovascular outcomes, decreased rehospitalization and reduced risk of mortality.
“Cardiovascular researchers have identified that optimism, positive psychological constructs, and subjective well‐being are linked to significantly better cardiovascular outcomes, decreased rehospitalization and reduced risk of mortality. 19 , 21 , 64 , 65 , 66”
From Positive psychological well-being in women with obesity: A scoping review of qualitative and quantitative primary research (2022) · cites this paper as [21]
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“, optimism, purpose, happiness) are associated with decreased CV morbidity and mortality in those with and without CV disease.(20,21) The American Heart Association asserts that PPWB should be considered an independent factor as current data strongly suggest a causal role in better cardiovascular health.”
Background
- Authors
- DuBois, C. M., Lopez, O. V., Beale, E. E., Healy, B. C., Boehm, J. K., & Huffman, J. C.
- Affiliations
- Massachusetts General Hospital (US)
- Harvard University (US)
- Chapman University (US)
- Corresponding author
- Huffman, Jeff C.
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2015-09
- Volume
- 195
- Pages
- 265-280
- ISSN
- 0167-5273 (ISSN-L)
- PMC
- PMC4487518
- OpenAlex
- W1552694281
- Cited by
- 187
- References
- 83
- Citations by year
- 2026: 7 · 2025: 18 · 2024: 15 · 2023: 15 · 2022: 17 · 2021: 15 · 2020: 23 · 2019: 20 · 2018: 23 · 2017: 17 · 2016: 13 · 2015: 3
- FWCI
- 3.22
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Chapman University Digital Commons (Chapman University) (submittedVersion, cc-by-nc-nd)
- Funders
- National Institutes of Health
- National Heart, Lung, and Blood Institute (R01HL113272)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Psychology › Applied Psychology › Optimism, Hope, and Well-being
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Keywords
- cardiovascular disease, optimism, health outcomes, mortality, hospital readmission, self-rated health, cardiac patients, positive psychology interventions
- MeSH terms
- Optimism, Attitude to Health, Cardiovascular Diseases, Humans, Treatment Outcome, Sickness Impact Profile
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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