Positive psychological well-being and cardiovascular disease: Exploring mechanistic and developmental pathways

Empirical research regarding the health benefits of positive psychological well-being (e.g., positive emotions, life satisfaction, purpose in life, and optimism) has flourished in recent years, particularly with regard to cardiovascular disease. This paper reviews the state of evidence for well-being's association with cardiovascular disease in both healthy individuals and those diagnosed with a disease. Prospective studies consistently indicate well-being reduces cardiovascular events in healthy and, to a lesser extent, patient populations. Potential pathways that link well-being with cardiovascular disease are discussed (including health behaviors, physiological processes, and stress buffering), although the existing evidence is mostly cross-sectional which limits conclusions about directionality. Issues related to development across the lifespan are considered and childhood is identified as a crucial period for establishing healthy cardiovascular trajectories. Outstanding questions for future research are provided with recommendations to focus on well-powered and prospective study designs with rigorous assessment of both well-being and cardiovascular-related outcomes.