Positive affect is not associated with incidence of cardiovascular disease: a population-based study of older persons

Prev Med. 2015 May;74:14-20. doi: 10.1016/j.ypmed.2015.01.032. Epub 2015 Feb 7.


Introduction: The relationship between positive psychological well-being (PPWB) and cardiovascular disease (CVD) is inconsistent across different CVD outcomes and for different PPWB constructs, such as positive affect. In addition, the relationship between PPWB and CVD as a composite measure is rarely assessed.

Objective: To assess whether positive affect is protective of incident CVD.

Method: Positive affect was assessed in two cohorts between 1993 and 2001 in Rotterdam using relevant questions from the Center for Epidemiological Studies Depression (CES-D) scale and the Hospital Anxiety and Depression Scale (HADS; in a sub-sample) in 6349 non-demented, CVD-free, consenting adults, aged 55+years. Composite CVD was defined as stroke, heart failure and coronary heart disease, which were continuously monitored through medical records until 1st April 2010.

Results: There were 1480 (23.3%) first time CVD events during follow-up (11.9 ± 2.8 SD years, 58,416 person-years). Positive affect was not associated with incident CVD (CES-D HR: 1.00 per point, 95% CI: 0.98-1.02; HADS HR: 0.98, 95% CI: 0.92-1.05). Stratification by age or sex and assessment of separate CVD outcome did not change results.

Conclusion: In this large, population-based study, there was no association between positive affect and twelve-year incident CVD in older adults who were free of diagnosed CVD at baseline.

Keywords: Cardiovascular disease; Coronary heart disease; Happiness; Heart failure; Positive affect; Stroke; Well-being.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Affect
  • Aged
  • Anxiety Disorders*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / prevention & control*
  • Cardiovascular Diseases / psychology
  • Depressive Disorder*
  • Female
  • Happiness*
  • Health Surveys
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Netherlands
  • Personal Satisfaction*
  • Population Surveillance
  • Protective Factors
  • Risk Factors