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Health Psychol. 2015 Oct;34(10):1043-6. doi: 10.1037/hea0000228. Epub 2015 Apr 13.

Positive psychological health and stroke risk: The benefits of emotional vitality.

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Department of Veterans Affairs, VA Pittsburgh Healthcare System.
Department of Social and Behavioral Sciences, Harvard School of Public Health.
Department of Psychiatry, University of Pittsburgh School of Medicine.



Stroke is a leading cause of death and disability. Various forms of positive psychological health (e.g., emotional vitality) are associated with lower risk for heart disease. However, it is unclear whether positive psychological health may also be beneficial for stroke risk. The purpose of the present study was to examine prospectively the association between emotional vitality and incident stroke in a nationally representative sample of 6,019 participants in the first National Health and Nutrition Examination Survey Epidemiologic Follow-up Study.


Emotional vitality was assessed via self-report at study baseline in 1971-1975. Stroke cases were identified from hospital/nursing home discharge reports and death certificates. Multivariate Cox proportional hazards regression models were used to estimate hazard ratios and 95% confidence intervals of incident stroke associated with a 1 SD increase in emotional vitality scores. Models were adjusted for traditional cardiovascular disease risk factors and subsequently for psychological distress.


Higher emotional vitality was associated with lower risk of incident stroke over a mean of 16.29 (SD = 4.75) years of follow-up (hazard ratio = 0.89; 95% confidence interval: 0.81, 0.99). Findings persisted when controlling for traditional cardiovascular disease risk factors and psychological distress.


Higher levels of emotional vitality were prospectively associated with lower stroke risk in a representative sample of the U.S.


Associations were independent of psychological distress. Results point to the potential importance of positive psychological functioning for cardiovascular health and for stroke prevention. (PsycINFO Database Record

[Indexed for MEDLINE]

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