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Emotional Health = Heart Health

Emotional vitality seems protective against coronary heart disease.

The association between depression and coronary heart disease (CHD) has been established. To determine whether emotional vitality decreases the risk for developing CHD, researchers analyzed data from a prospective study of healthy, civilian, noninstitutionalized people. At baseline, a subset of 6265 participants underwent medical evaluation and testing for emotional vitality and was then followed for 15 years.

Emotional vitality was defined as a sense of positive energy, an ability to regulate behavior and emotions, and a feeling of engagement in life. After adjustment for cardiovascular risk factors and history of psychological problems, subjects with the highest level of emotional vitality had 81% of the CHD risk of those with the lowest levels of emotional vitality. Controlling for positive health behaviors (e.g., less smoking, more physical activity) somewhat weakened the results. Metabolic factors also explained some of the benefit of emotional vitality; for example, lower cholesterol levels were associated with emotional vitality. Still, even after adjustment for these covariates and for additional factors such as depression and use of psychotropic medications, the benefit of emotional vitality itself remained significant.

Comment: A factor common to both high emotional vitality and low CHD risk might underlie these results. Alternatively, dietary factors, which were not assessed, could explain the benefits of emotional vitality. However, this study and others have produced enough evidence of the health benefit of a positive and flexible orientation toward life to warrant promoting such traits, whereas negative emotional states may injure the heart (Journal Watch Psychiatry Nov 5 2007 and Nov 27 2006). Emphasizing positive adaptations rather than focusing exclusively on things that patients do wrong could have the potential to improve heart health.

— Steven Dubovsky, MD

Published in Journal Watch Psychiatry January 28, 2008

Citation(s):

Kubzansky LD and Thurston RC. Emotional vitality and incident coronary heart disease: Benefits of healthy psychological functioning. Arch Gen Psychiatry 2007 Dec; 64:1393.

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