A Prospective Study of Positive Psychological Well-Being and Coronary Heart Disease

People who have positive psychological well-being feel good about their life and function well in the world. But are they also healthier? Does psychological well-being contribute to better cardiovascular health and less coronary heart disease (CHD)?

The emerging concept of Positive Health explores these questions and more to identify potential health assets associated with a healthier and longer life, lower health care costs, and improved prognosis when illness strikes. In this study, researchers looked at the association between psychological well-being—specifically, emotional vitality and optimism—on CHD in middle-aged men and women. The participants were 7,942 British civil servants in the Whitehall II study measured at baseline and five years later.

Emotional vitality was defined as active engagement with the world, effective emotional regulation and an overall sense of well-being. Optimism was assessed by participants rating themselves on a scale of 1 to 6 in their response to the statement: “Over the next 5–10 years I expect to have more positive than negative experiences.” Numerous cardiovascular risk factors were measured including smoking, alcohol consumption, exercise, fruit and vegetable consumption and blood pressure/metabolic factors.

The researchers found that greater emotional vitality and optimism both were protective factors against CHD. Metabolic factors did not alter this finding, which was similar for men and women, and for individuals younger and older than 55.

Positive psychological well-being, desirable in itself, is a potential health asset that may have far-reaching consequences for cardiovascular health.


This study is one in a series supported by the Robert Wood Johnson Foundation’s Pioneer Portfolio to explore Positive Health, an emerging concept that seeks to demonstrate that in addition to health risks, people also have health assets, which can be strengthened to produce a healthier life. These health assets could include biological factors, such as high heart rate variability; subjective factors, such as optimism; and functional factors, such as a stable marriage.