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Don't worry, be happy: positive affect and reduced 10-year incident coronary heart disease: The Canadian Nova Scotia Health Survey
Open accessAbstract
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* | 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]
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“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]
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“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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"Don't worry, be happy"--may be a first line therapy in cardiovascular diseases?
Bălan, H., & Popescu, L. (2013) · PubMed
Metadata
- 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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