title: Subjective well-being and cardiometabolic health: An 8-11year study of midlife adults.
abstract: Individuals who are satisfied and experience frequent positive emotions tend to have reduced risk for coronary heart disease (CHD). However, conflicting evidence exists and little research has investigated whether well-being is associated with early-warning indicators of biological risk that precede CHD. We investigated whether life satisfaction and positive emotions longitudinally predicted reduced risk of incident cardiometabolic conditions and healthier cardiometabolic risk scores, which may provide insight into underlying mechanisms and novel prevention targets.
  
  
  
  Initially healthy men and women (N=754-854) reported their baseline life satisfaction and positive emotions. During follow-up, presence of manifest cardiometabolic conditions was assessed and a separate cardiometabolic risk score was constructed from eight biomarkers. Poisson and linear regression analyses tested whether life satisfaction and positive emotions were associated with reduced incident disease risk and lower cardiometabolic risk scores 8-11years later.
  
  
  
  Life satisfaction and positive emotions were each prospectively associated with reduced risk of manifest conditions, controlling for demographics and family history of CHD. Associations were attenuated for positive emotions after adjusting for depressive symptoms and for life satisfaction after adjusting for health behaviors. Life satisfaction was associated with lower cardiometabolic risk scores until adding health behaviors, but positive emotions were not (regardless of the included covariates).
  
  
  
  Well-being, particularly life satisfaction, is associated with reduced risk for incident cardiometabolic conditions in minimally-adjusted models. However, accounting for underlying behavioral pathways attenuates the association. Low levels of life satisfaction (but not positive emotions) may also provide early warning of cardiometabolic risk prior to disease development.
authors.affiliation: Department of Psychology, Chapman University, One University Drive, Orange, CA 92866, United States. Electronic address: jboehm@chapman.edu.
authors.forename: Julia K
authors.initials: JK
authors.lastname: Boehm
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA 02115, United States.
authors.forename: Ying
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA 02115, United States; Department of African and African American Studies and Sociology, Harvard University, Cambridge, MA 02138, United States.
authors.forename: David R
authors.initials: DR
authors.lastname: Williams
authors.affiliation: Department of Psychology, University of Wisconsin, Madison, 1202 West Johnson Street, Madison, WI 53706, United States; Institute on Aging, University of Wisconsin, Madison, 1300 University Avenue, Madison, WI 53706, United States.
authors.forename: Carol D
authors.initials: CD
authors.lastname: Ryff
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA 02115, United States.
authors.forename: Laura D
authors.initials: LD
authors.lastname: Kubzansky
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology / Q000523:psychology*; D003863:Depression / Q000503:physiopathology; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D016014:Linear Models; D008297:Male; D008659:Metabolic Diseases / Q000209:etiology / Q000523:psychology*; D008875:Middle Aged; D010549:Personal Satisfaction; D016012:Poisson Distribution; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors
keywords: Cardiometabolic risk; Coronary heart disease; Incident cardiometabolic conditions; Life satisfaction; Positive emotions; Subjective well-being