TY - JOUR
T1 - Effect of positive well-being on incidence of symptomatic coronary artery disease
AU - Yanek, Lisa R.
AU - Kral, Brian G.
AU - Moy, Taryn F.
AU - Vaidya, Dhananjay
AU - Lazo, Mariana
AU - Becker, Lewis C.
AU - Becker, Diane M.
N1 - Funding Information:
This study was supported in part by grants NR02241 , R01 HL49762 , and R01 HL59684 from the National Institutes of Health (Bethesda, Maryland) and grant M01 RR00052 from the National Institutes of Health (Bethesda, Maryland) to Johns Hopkins University School of Medicine General Clinical Research Center.
PY - 2013/10/15
Y1 - 2013/10/15
N2 - Although negative emotions and psychiatric morbidity have often been found to increase incident coronary artery disease (CAD) risk, fewer studies have shown positive emotions to be protective against CAD; none have been performed in high-risk healthy populations, taking risk factors into account. Thus, we examined the effect of positive well-being on incident CAD in both a high-risk initially healthy population and a national probability sample. We screened healthy siblings of probands with documented early-onset CAD from 1985 to 2007 in the GeneSTAR (Genetic Study of Atherosclerosis Risk) population and examined sociodemographic data, risk factors, and positive well-being using the General Well-Being Schedule. We further classified siblings into high-, intermediate-, and low-risk strata according to the Framingham risk score and followed them for 5 to 25 years. Siblings (n = 1,483) with greater baseline General Well-Being Schedule total scores were significantly less likely to develop CAD (hazard ratio 0.67, 95% confidence interval 0.58 to 0.79), independent of age, gender, race, and traditional risk factors. Protection was strongest in the high Framingham risk score stratum (hazard ratio 0.52, 95% confidence interval 0.30 to 0.90). The findings were replicated in the first National Health and Nutrition Examination Survey and Epidemiologic Follow-up Study (n = 5,992; hazard ratio 0.87, 95% confidence interval 0.83 to 0.93). In conclusion, positive well-being was associated with nearly a 1/3 reduction in CAD in a high-risk population with a positive family history, a nearly 50% reduction in incident CAD in the highest risk stratum in those with a positive family history, and a 13% reduction in incident CAD in a national probability sample, independent of the traditional CAD risk factors.
AB - Although negative emotions and psychiatric morbidity have often been found to increase incident coronary artery disease (CAD) risk, fewer studies have shown positive emotions to be protective against CAD; none have been performed in high-risk healthy populations, taking risk factors into account. Thus, we examined the effect of positive well-being on incident CAD in both a high-risk initially healthy population and a national probability sample. We screened healthy siblings of probands with documented early-onset CAD from 1985 to 2007 in the GeneSTAR (Genetic Study of Atherosclerosis Risk) population and examined sociodemographic data, risk factors, and positive well-being using the General Well-Being Schedule. We further classified siblings into high-, intermediate-, and low-risk strata according to the Framingham risk score and followed them for 5 to 25 years. Siblings (n = 1,483) with greater baseline General Well-Being Schedule total scores were significantly less likely to develop CAD (hazard ratio 0.67, 95% confidence interval 0.58 to 0.79), independent of age, gender, race, and traditional risk factors. Protection was strongest in the high Framingham risk score stratum (hazard ratio 0.52, 95% confidence interval 0.30 to 0.90). The findings were replicated in the first National Health and Nutrition Examination Survey and Epidemiologic Follow-up Study (n = 5,992; hazard ratio 0.87, 95% confidence interval 0.83 to 0.93). In conclusion, positive well-being was associated with nearly a 1/3 reduction in CAD in a high-risk population with a positive family history, a nearly 50% reduction in incident CAD in the highest risk stratum in those with a positive family history, and a 13% reduction in incident CAD in a national probability sample, independent of the traditional CAD risk factors.
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U2 - 10.1016/j.amjcard.2013.05.055
DO - 10.1016/j.amjcard.2013.05.055
M3 - Article
C2 - 23810324
AN - SCOPUS:84884905338
SN - 0002-9149
VL - 112
SP - 1120
EP - 1125
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 8
ER -