Happiness and Heart Health: What’s the Link?

Can being upbeat contribute to better cardiovascular health? Research has uncovered interesting connections.

a middle aged Hispanic woman smiles with eyes closed, resting her hands gently over her heart

Medically reviewed in July 2022

Updated on July 22, 2022

If you had to choose a theme song for your life, would it be "(I Can't Get No) Satisfaction" or "Don't Worry Be Happy"?

Good news if you picked the latter: You may be less likely to have a heart attack.

Mounting evidence shows an association between happiness and heart health. Being happy may decrease the likelihood of developing cardiovascular disease—and reduce its risks if you already have it. No matter the condition of your heart, it seems to be in better shape overall when you have a smile on your face.

Exploring the links between mood and heart health
It's long been known that depression, anxiety, and stress increase one’s risk for heart disease. There’s comparatively less research, however, on whether positive emotions can prevent coronary trouble. What evidence there is suggests compelling links.

In an influential study from the Harvard School of Public Health published in 2011 in the European Heart Journal, scientists asked nearly 8,000 people to rate their satisfaction in seven key areas of life: jobs, family, love, leisure, standard of living, sex, and self. Participants with above-average satisfaction in all of these categories showed up to 13 percent lower risk of heart disease, heart attacks, and angina (chest pain associated with heart disease). The study found that those who were happier with their jobs, families, sex lives, and selves in particular had healthier hearts. Researchers did not see the same link for those satisfied with their leisure activities, love relationships, or standard of living.

One’s outlook on life appears to play a role in heart health, too. One 2015 study published in Health Behavior and Policy Review of more than 5,000 people found that participants with the highest levels of optimism had a 92 percent higher chance of having ideal cardiovascular health, compared to the study’s most pessimistic participants.

Similarly, a 2016 study published in the American Journal of Epidemiology looking at more than 70,000 older women found that those with the highest levels of optimism had a 38 percent lower risk of heart disease mortality and a 39 percent lower risk of stroke mortality than those with the lowest levels of optimism.

Other studies have found that optimism predicts lower risk of heart failure and stroke. Even when optimistic people do have cardiovascular problems to begin with, they appear to have less adverse effects and lower rates of death. It seems that the better your outlook on life, the more likely you are to be healthy—and to be better equipped to handle health issues.

How happiness may influence heart health
The jury is still out on exactly how and to what extent happiness can affect heart health, but researchers have identified three promising theories that help explain the connection. These theories—or pathways—involve the biological or physical connections between happiness and heart health, the possible behavioral links, and a third pathway that involves the relationship between stress and hearth health.

The physical connection: Happiness has been linked to a slew of positive physical effects, including better immune system function, lower levels of inflammation, lower heart rate, and lower blood pressure. It’s possible that being happy has a direct effect on your body to promote heart health.

The behavioral connection: Another potential explanation is that happier people tend to engage in heart-healthy behaviors like exercising, following a healthier diet, taking their prescribed medications, and socializing, while avoiding unhealthy behaviors like smoking.

The relationship may work in the other direction, as well. A 2016 meta-analysis published in Heart found that folks who reported poor social relationships were 29 percent more likely to have coronary heart disease and 32 percent more likely to have a stroke. Research shows that being sedentary, isolated, and eating unhealthfully puts more of a strain on your heart than does working up a sweat, spending time with friends, and eating well—all habits associated with a positive mental outlook.

The stress connection: A further thought is that having a positive mental outlook provides protection against the detrimental effects of stress. For example, optimistic people may have broader and deeper social networks, which may help them weather the effects of life’s stressors. And that, in turn, may contribute to better heart health.

Some research also suggests that positive mental well-being may reduce the impact of physical stressors on the body, such as by lowering levels of inflammation in the body, effectively providing a buffer for the body and heart against stress.

What can I do about it?
There are many factors outside of one’s control that can contribute to (or diminish) one’s sense of happiness. These include socioeconomic status, childhood experiences, and experiences with racism and discrimination. There may even be a genetic predisposition toward happiness. Some research shows that one’s tendency toward being optimistic may be as high as 47 percent based on heredity.

But what you can control, at least in part, is your response to the ups and downs of life. Happy people don’t necessarily experience fewer negative experiences or emotions, but they tend to be skilled at processing them. Finding ways to cope with the stresses in your life helps encourage overall happiness.

Developing habits that promote happiness or optimism may include the following (and many of these also have direct benefits for your heart health, making them a win-win):

Getting regular exercise. Most experts advise that adults get at least 150 minutes of moderate-intensity physical activity a week. Any kind of aerobic exercise—whether walking, running, biking, or swimming—provides a mood boost and improves cardiovascular health directly in the process.

Eating healthfully. That means reducing your intake of saturated fats from red and processed meats and empty calories from sugary drinks and overly processed foods and emphasizing instead a whole food diet built around fruits and vegetables, whole grains, beans and legumes, low-fat dairy, lean proteins (like fish and poultry or plant-based proteins like tofu), and heart-healthy fats like those found in seafood and vegetable oils.

Sleeping well. Getting seven to nine hours nightly of quality, restful sleep benefits your overall mood and outlook and gives your body the chance to restore and repair.

Manage habits. That means quitting if you smoke and limiting alcohol intake to one drink per day for women and two drinks per day for men.

Being mindful. There are many ways to manage stress (including exercising), but mindfulness-based practices like yoga, meditation, and tai chi are low-cost, easy to learn, and accessible most anywhere. Not only can mindfulness ease stress and improve outlook, it has been shown to have heart benefits, including lowering blood pressure.

Talking it out. Working through life’s challenges with trusted friends or loved ones can help you improve your outlook on life. If a trusted ear is not readily available to you, speaking with a mental health professional can help you find your sense of purpose and help you find reasons to be optimistic in life. Likewise, if you’re experiencing stress, anxiety, or symptoms of depression on a consistent basis, a counselor or therapist can provide life-saving insight and assistance.

There’s still much to be learned about what it means to be happy and how and when it affects your health. More research is needed to better understand how boosting happiness and enhancing your sense of optimism can improve heart health. For the time being, indications are that a happier mind helps lead toward a happier heart.

Article sources open article sources

Diener, E., Pressman, S.D., Hunter, J. and Delgadillo-Chase, D. (2017), If, Why, and When Subjective Well-Being Influences Health, and Future Needed Research. Appl Psychol Health Well-Being, 9: 133-167.
Julia K. Boehm, Christopher Peterson, Mika Kivimaki, Laura D. Kubzansky, Heart health when life is satisfying: evidence from the Whitehall II cohort study, European Heart Journal, Volume 32, Issue 21, November 2011, Pages 2672–2677.
Kubzansky, Laura D. et al., Positive Psychological Well-Being and Cardiovascular Disease: JACC Health Promotion Series, Journal of the American College of Cardiology, Volume 72, Issue 12, 2018, Pages 1382-1396, ISSN 0735-1097.
Sin NL. The Protective Role of Positive Well-Being in Cardiovascular Disease: Review of Current Evidence, Mechanisms, and Clinical Implications. Curr Cardiol Rep. 2016 Nov;18(11):106.
Hernandez R, Kershaw KN, Siddique J, et al. Optimism and Cardiovascular Health: Multi-Ethnic Study of Atherosclerosis (MESA). Health Behav Policy Rev. 2015;2(1):62-73.
Tindle HA, Chang YF, Kuller LH, Manson JE, Robinson JG, Rosal MC, Siegle GJ, Matthews KA. Optimism, cynical hostility, and incident coronary heart disease and mortality in the Women's Health Initiative. Circulation. 2009 Aug 25;120(8):656-62.
Cathrine Lawaetz Wimmelmann, Naja Kirstine Andersen, Marie Stjerne Grønkjaer, Emilie Rune Hegelund & Trine Flensborg-Madsen (2021) Satisfaction with life and SF-36 vitality predict risk of ischemic heart disease: a prospective cohort study, Scandinavian Cardiovascular Journal, 55:3, 138-144.
Valtorta NK, Kanaan M, Gilbody S, et al. Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart 2016;102:1009-1016.

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