Emotional vitality and incident coronary heart disease: benefits of healthy psychological functioning.
BACKGROUND
The potentially toxic effects of psychopathology and poorly regulated emotion on physical health have long been considered, but less work has addressed whether healthy psychological functioning may also benefit physical health. Emotional vitality--characterized by a sense of energy, positive well-being, and effective emotion regulation--has been hypothesized to reduce risk of heart disease, but no studies have examined this relationship.


OBJECTIVE
To examine whether emotional vitality is associated with reduced risk of coronary heart disease (CHD). Secondary aims are to consider whether effects are independent of negative emotion and how they may occur.


METHODS
A prospective population-based cohort study.


METHODS
National Health and Nutrition Examination Survey I and follow-up studies (a probability sample of US adults).


METHODS
Six thousand twenty-five men and women aged 25 to 74 years without CHD at baseline, followed up for a mean 15 years after the baseline interview.


METHODS
Measures of incident CHD were obtained from hospital records and death certificates. During the follow-up period, 1141 cases of incident CHD occurred.


RESULTS
At the baseline interview (1971-1975), participants completed the General Well-being Schedule from which we derived a measure of emotional vitality. Compared with individuals with low levels, those reporting high levels of emotional vitality had multivariate-adjusted relative risks of 0.81 (95% confidence interval, 0.69-0.94) for CHD. A dose-response relationship was evident (P < .001). Significant associations were also found for each individual emotional vitality component with CHD, but findings with the overall emotional vitality measure were more reliable. Further analyses suggested that one way in which emotional vitality may influence coronary health is via health behaviors. However, the effect remained significant after controlling for health behaviors and other potential confounders, including depressive symptoms or other psychological problems.


CONCLUSIONS
Emotional vitality may protect against risk of CHD in men and women.
Kubzansky
Laura D
LD
Department of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA. lkubzans@hsph.harvard.edu
Thurston
Rebecca C
RC
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology*; D019260:Expressed Emotion; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D011446:Prospective Studies; D011795:Surveys and Questionnaires