Don't worry, be happy: positive affect and reduced 10-year incident coronary heart disease: The Canadian Nova Scotia Health Survey
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AIMS: Positive affect is believed to predict cardiovascular health independent of negative affect. We examined whether higher levels of positive affect are associated with a lower risk of coronary heart disease (CHD) in a large prospective study with 10 years of follow-up. METHODS AND RESULTS: We examined the association between positive affect and cardiovascular events in 1739 adults (862 men and 877 women) in the 1995 Nova Scotia Health Survey. Trained nurses conducted Type A Structured Interviews, and coders rated the degree of outwardly displayed positive affect on a five-point scale. To test that positive affect predicts incident CHD when controlling for depressive symptoms and other negative affects, we used as covariates: Center for Epidemiological Studies Depressive symptoms Scale, the Cook Medley Hostility scale, and the Spielberger Trait Anxiety Inventory. There were 145 (8.3%) acute non-fatal or fatal ischaemic heart disease events during the 14 916 person-years of observation. In a proportional hazards model controlling for age, sex, and cardiovascular risk factors, positive affect predicted CHD (adjusted HR, 0.78; 95% CI 0.63-0.96 per point; P = 0.02), the covariate depressive symptoms continued to predict CHD as had been published previously in the same patients (HR, 1.04; 95% CI 1.01-1.07 per point; P = 0.004) and hostility and anxiety did not (both P > 0.05). CONCLUSION: In this large, population-based study, increased positive affect was protective against 10-year incident CHD, suggesting that preventive strategies may be enhanced not only by reducing depressive symptoms but also by increasing positive affect.
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Happiness/more positive affect is associated with lower incident coronary heart disease (HR, 0.78; 95% CI, 0.63-0.96).
“Happiness/more positive affect* | Incident CHD | HR, 0.78 (0.63-0.96) 93”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [93]
Positive psychological states such as positive affect or optimism are prospectively and independently linked to improvements in health behaviors.
“these constructs have been prospectively and independently linked to improvements in health behaviors.”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [36]
The effects of positive states on health behaviors and outcomes in medical illnesses persist even after accounting for negative affect/depression.
“Furthermore, the effects of positive states on health behaviors and outcomes in medical illnesses persist even after accounting for negative affect/depression [25, 28, 29, 36].”
From Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development (2015) · cites this paper as [36]
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- Authors
- Davidson, K. W., Mostofsky, E., & Whang, W.
- Affiliations
- Columbia University Irving Medical Center (US)
- Corresponding author
- Davidson, K. W.
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-02-17
- Volume
- 31
- Issue
- 9
- Pages
- 1065-1070
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- PMC
- PMC2862179
- OpenAlex
- W2168019533
- Cited by
- 334
- References
- 44
- Citations by year
- 2026: 8 · 2025: 15 · 2024: 11 · 2023: 15 · 2022: 22 · 2021: 18 · 2020: 19 · 2019: 24 · 2018: 23 · 2017: 27 · 2016: 31 · 2015: 21 · 2014: 20 · 2013: 21 · 2012: 28
- FWCI
- 17.78
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Heart Journal (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Columbia Academic Commons (Columbia University)
- Funders
- Heart and Stroke Foundation of Canada
- National Institutes of Health (n01hc25197-0-0-0, RR024156)
- National Heart, Lung, and Blood Institute (HC25197, R24HL076857, K24HL084034, R01HL080665, K23HL004458, HL088117, HL04458, HL-084034, HL-076857, N01 HC025197, HL-080665, P01HL088117)
- National Center for Research Resources (UL1RR024156)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Keywords
- positive affect, coronary artery disease, depressive symptoms, hostility, trait anxiety, cardiovascular risk, ischemic heart disease, emotional well-being, cardiovascular disease prevention
- MeSH terms
- Adult, Aged, Antidepressive Agents, Anxiety, Coronary Disease, Depressive Disorder, Female, Hostility, Humans, Male, Middle Aged, Nova Scotia, Risk Factors, Incidence, Young Adult
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