For decades, heart health advice has focused on a few key pillars: Eat healthily, exercise, don’t smoke, and manage cholesterol, blood pressure and stress.
But there’s a growing body of research that suggests there may be a less obvious factor that can influence cardiovascular health: optimism.
Several studies have linked having a sunnier outlook on life to a lower risk of heart disease, stroke and premature death. In 2021, the American Heart Association released a scientific statement on the mind-heart-body connection, explaining that psychological well-being is an important factor in cardiovascular health.
The good news is that even if you’re not a natural optimist, there are things you can do to reap the benefits of optimistic thinking to help protect your heart.
In a new study, researchers found that “positive psychology interventions” — including gratitude exercises, optimism training and mindfulness-based practices — are associated with consistent improvements in cardiovascular risk factors and health behaviors.
“Positive psychological interventions are structured strategies designed to help people build emotional resilience,” said Rosalba Hernandez, an associate professor of social work at the University of Illinois at Urbana-Champaign, who led the study. “It’s not about ignoring stress or forcing people to feel happy all the time. It’s about building emotional resources.”
Hernandez and her team analyzed the findings of 18 randomized controlled trials of positive psychology interventions in adults at risk of, or already living with, cardiovascular disease. The interventions are intended to teach people specific skills: identifying positive events in life and appreciating them, committing acts of kindness, mindfulness meditation, and recognizing personal strengths.
The skills were practiced at home through assignments and exercises over several weeks, typically in addition to weekly group sessions.
Across the trials, participants showed measurable improvements in blood pressure and inflammatory markers after eight to 12 weeks. For instance, some interventions reduced systolic blood pressure by 4 to 8 points, which Hernandez said is clinically significant.
A central finding of the study, which was published this month in the journal Cardiology Clinics, is that consistency is key. Programs that combined daily practice with weekly structured sessions yielded the strongest results, and those that taught multiple skills outperformed those that only focused on one.
While these practices are not meant to replace medication, exercise or a healthy diet, Hernandez said, they can complement them.
“Positive emotion really does have an impact — both directly and indirectly,” Hernandez said.
The mind-heart connection
The connection between mental outlook and heart health works in both biological and behavioral ways, according to Alan Rozanski, a behavioral cardiologist and professor of medicine at the Icahn School of Medicine at Mount Sinai in New York. Rozanski was not involved in the study but has led his own research on the heart-mind connection.
When people persistently experience stress, emotional strain or pessimism, the body responds, he said. Stress hormones surge, insulin resistance can rise, and inflammation increases.
“These things can cause a negative spiral in health, which compounds over time,” Rozanski said.
The opposite appears to be true as well — that optimism may help dial down the same negative biological responses.
“With optimism and pessimism, you see differences in inflammation, cortisol levels and insulin resistance,” said Rozanski, who led a 2019 study that looked at how optimism relates to cardiovascular events and mortality due to any cause.
In the study, Rozanski and colleagues analyzed data from more than 229,000 people and found that those with higher levels of optimism had a 35 percent lower risk of cardiovascular events, and a 14 percent lower risk of death by any cause. Rozanski’s team defined optimism as “the tendency to think that good things will happen in the future.”
“Optimism really has a profound effect,” Rozanski said.
Beyond biological outcomes, optimism may lead to improved health behaviors as well. Optimistic people tend to exercise more frequently, eat better and engage in healthier lifestyles overall, according to research by Julia Boehm, a professor of psychology at Chapman University.
“If we’re feeling more optimistic about our future, then we probably think that the things we do today are going to have an impact on the way our future turns out,” said Boehm, who was not part of the new study.
How to reframe your thoughts if you want to be more optimistic
Some people view pessimism as a protection mechanism against disappointment. But researchers say that mindset is typically a learned behavior, and it can harm heart health.
“You can take pessimists and learn how to reframe their negative thoughts,” Rozanski said. “It’s a process of learning how to notice your negative thoughts in the first place.”
While some people are naturally wired to be more pessimistic than others, Rozanski said, optimism can be developed — something Rozanski said he has witnessed repeatedly in his career. With practice, people can shift their outlook to be markedly more positive.
“Work on building little optimism before big optimism,” he said. “There are many roads to becoming more optimistic, and the goal is just to start with one of them.”
Structured programs like those mentioned in Hernandez’s study have shown clear benefits, he added. But the trick is sticking with them.
“We have lots of tools and pathways to flourish,” Rozanski said. “The magic sauce of change is consistency.”
The researchers do not endorse toxic positivity, but rather developing tools that help people handle stress and feel more hopeful about life.
Here are a few evidence-based habits that researchers say can promote optimism over time:
Keep a gratitude journal. A few times a week, write down three things that went well that day. They don’t need to be major events, Hernandez said — small moments count, such as a delicious meal, a refreshing walk or a meaningful conversation. Over time, the practice can retrain your brain to focus more on the good in your life.
“You can learn how to be a more grateful person, and eventually it becomes part of your background furniture,” Rozanski said.
Slow down. Step away from constant stimulation for a few minutes each day. That can mean a walk in nature, time without your phone or simply enjoying a moment of silence. This promotes relaxation and gives you the time and space to take note of how you’re feeling.
Meditate. Mindfulness meditation was one of the most-examined practices in Hernandez’s review. The programs encouraged participants to meditate between 20 and 45 minutes a day, but even very short sessions can reduce stress.
“Take a few minutes each day for mindful breathing or reflection,” Hernandez advised.
Think about your best self. A common exercise in optimism literature, Boehm said, is called “imagining your best possible self.” It involves thinking about how you might live your best life in the coming months or years, and the steps it would take to get you there. This exercise should focus on realistic outcomes, not grand or improbable visions that could set you up for disappointment.
Set small goals. Start with something concrete, such as a daily walk or trying a new recipe once a week. These small, realistic goals and commitments can go a long way in building optimism.
“That’s how we make progress and achieve things in our lives,” Boehm said.
Move. Just as optimism can spur someone to exercise more, Rozanski said, exercise itself can make people more optimistic.
“You can’t separate the mental from the physical,” he said.
What’s still unknown
Researchers emphasize that although the findings on positive psychology and heart health are encouraging, several important questions remain unanswered.
The trials in Hernandez’s study lasted up to 12 weeks, making it difficult to know whether the cardiovascular benefits of positive psychology interventions would hold up long term, or whether people would need to constantly practice the skills to maintain the benefits.
“I suspect people will have to continue engaging in the activities to continue seeing effects,” Boehm said.
Most of the existing research on optimism and heart health is focused on people who already have heart disease or elevated risk factors, raising questions about whether starting these practices earlier could be preventative.
“It’s a very different question to be asking ‘Can we improve outcomes for people who have already been diagnosed with diseases?’ versus ‘Can we prevent people from getting diagnosed in the first place?’” Boehm said.
Hernandez also noted that more research is needed in diverse and real-world settings.
Still, all three researchers agreed the evidence so far is promising — and worth considering in a medical culture that has traditionally focused on treating illnesses more than cultivating well-being.
“What we haven’t done enough of is emphasizing the positive factors that can lead to better health,” Rozanski said. “We now have considerable data that we know how to help people flourish more in life.”
The post Studies link optimism to better heart health, lower risk of disease appeared first on Washington Post.
