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Objective: Individuals who are satisfied and experience frequent positive emotions tend to have reduced risk for coronary heart disease (CHD). However, conflicting evidence exists and little research has investigated whether well-being is associated with early-warning indicators of biological risk that precede CHD. We investigated whether life satisfaction and positive emotions longitudinally predicted reduced risk of incident cardiometabolic conditions and healthier cardiometabolic risk scores, which may provide insight into underlying mechanisms and novel prevention targets.

Methods: Initially healthy men and women (N=754–854) reported their baseline life satisfaction and positive emotions. During follow-up, presence of manifest cardiometabolic conditions was assessed and a separate cardiometabolic risk score was constructed from eight biomarkers. Poisson and linear regression analyses tested whether life satisfaction and positive emotionswere associated with reduced incident disease risk and lower cardiometabolic risk scores 8–11 years later.

Results: Life satisfaction and positive emotions were each prospectively associated with reduced risk of manifest conditions, controlling for demographics and family history of CHD. Associations were attenuated for positive emotions after adjusting for depressive symptoms and for life satisfaction after adjusting for health behaviors. Life satisfactionwas associated with lower cardiometabolic risk scores until adding health behaviors, but positive emotions were not (regardless of the included covariates).

Conclusion: Well-being, particularly life satisfaction, is associated with reduced risk for incident cardiometabolic conditions in minimally-adjusted models. However, accounting for underlying behavioral pathways attenuates the association. Low levels of life satisfaction (but not positive emotions) may also provide early warning of cardiometabolic risk prior to disease development.


NOTICE: this is the author’s version of a work that was accepted for publication in Journal of Psychosomatic Research. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Psychosomatic Research, volume 85, in 2016. DOI: 10.1016/j.jpsychores.2016.03.018

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