Positive emotions and favorable cardiovascular health: A 20-year longitudinal study

Prev Med. 2020 Jul:136:106103. doi: 10.1016/j.ypmed.2020.106103. Epub 2020 Apr 26.


No studies have examined whether positive emotions lead to favorable cardiovascular health (CVH) early in the lifespan, before cardiovascular disease is diagnosed. Moreover, the direction of the association has not been thoroughly investigated. Among younger adults, we investigated whether baseline positive emotions were associated with better CVH over 20 years. We also considered whether baseline CVH was associated with subsequent positive emotions during the same period. Participants included 4196 Black and White men and women from the Coronary Artery Risk Development in Young Adults Study. Positive emotions and cardiovascular-related parameters were each assessed in 1990 (this study's baseline), with repeated assessment through 2010. CVH was defined by blood pressure, lipids, body mass index, diabetes, and smoking status. Primary analyses used linear mixed effects models adjusting for potential confounders; secondary analyses stratified by race and sex. Controlling for sociodemographic factors, greater baseline positive emotions were associated with better CVH across time (β = 0.03, 95% confidence interval = 0.007-0.06). However, positive emotions were unrelated to rate of change in CVH across time. Baseline CVH was also associated with greater average positive emotions across time (β = 0.09, 95% confidence interval = 0.02-0.15), but not rate of change. Positive emotions' association with CVH was stronger for women than men, but race did not modify associations. Positive emotions in early to middle adulthood were associated with better CVH across several decades. Baseline CVH was also associated with greater positive emotions during follow-up. Future research may be able to disentangle these relationships by assessing positive emotions and CVH earlier in life.

Keywords: Cardiovascular disease; Cardiovascular health; Health promotion; Positive emotions.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Blood Pressure
  • Cardiovascular Diseases* / prevention & control
  • Emotions
  • Female
  • Health Status
  • Humans
  • Longitudinal Studies
  • Male
  • Risk Factors
  • Young Adult