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J Am Coll Cardiol. 2018 Sep 18;72(12):1382-1396. doi: 10.1016/j.jacc.2018.07.042.

Positive Psychological Well-Being and Cardiovascular Disease: JACC Health Promotion Series.

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Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.
Department of Psychology, Chapman University, Orange, California.
School of Social Work, University of Illinois at Urbana-Champaign, Champaign, Illinois.
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania.
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address:


Facets of positive psychological well-being, such as optimism, have been identified as positive health assets because they are prospectively associated with the 7 metrics of cardiovascular health (CVH) and improved outcomes related to cardiovascular disease. Connections between psychological well-being and cardiovascular conditions may be mediated through biological, behavioral, and psychosocial pathways. Individual-level interventions, such as mindfulness-based programs and positive psychological interventions, have shown promise for modifying psychological well-being. Further, workplaces are using well-being-focused interventions to promote employee CVH, and these interventions represent a potential model for expanding psychological well-being programs to communities and societies. Given the relevance of psychological well-being to promoting CVH, this review outlines clinical recommendations to assess and promote well-being in encounters with patients. Finally, a research agenda is proposed. Additional prospective observational studies are needed to understand mechanisms underlying the connection between psychological well-being and cardiovascular outcomes. Moreover, rigorous intervention trials are needed to assess whether psychological well-being-promoting programs can improve cardiovascular outcomes.


cardiovascular disease; cardiovascular health; health behaviors; optimism; positive psychological well-being


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