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Are you leading a heart-healthy lifestyle?

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Negative emotions like anger, anxiety, and depression have long been associated with heart disease, but what about the flip side? Can positive emotions like optimism, life satisfaction, and a sense of well-being actually lower your risk of having a heart attack or stroke?

Perhaps, according to a new review of more than 200 studies from the Harvard School of Public Health. The researchers found that those who scored high on the happiness index were less likely to be diagnosed with heart disease compared to those whose happiness scores reflected a more ho-hum existence.

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Specifically, three recent Japanese studies found that people who had a sense of mastery or control over their lives had a lower risk of dying from heart attacks or strokes, while an American study involving 2,500 American adults linked emotional well-being to a 26 percent reduced risk of stroke over a six-year period compared to those who had lower levels of well- being. Eight other studies found an association between optimism and a lower risk of heart disease.

“The effects of having a positive psychological well-being ranged from small, in some studies, to as large as the effect of canceling out a risk factor like diabetes,” said Julia Boehm, a positive psychology researcher and co-author of the study published last week in the journal Psychological Bulletin. Biological effects like lower blood pressure and lower levels of inflammatory markers also correlated in some studies with high levels of happiness.

There are, though, some caveats. Nearly all the studies reviewed by the researchers were population studies that assessed personality traits and heart disease risks to see if the two were connected. They didn’t prove that feeling happy actually protected the heart muscle and arteries. The researchers also found that having a sense of greater well-being was associated with having better health habits like optimal sleep, exercise, and nutrition ­— all of which lower the likelihood of heart disease.

“We really can’t determine if people are happier because they’re exercising for example,” said Boehm, “or if their high level of happiness leads them to exercise.” What’s more, it’s really tough to tease out how much of the lower heart disease risk can be attributed to healthier habits and how much to having an upbeat personality.

I was also disappointed to hear that only a handful of preliminary studies tested interventions to see whether boosting your mood could actually lower heart disease risk factors. “We’re hoping to look at that in the future,” said Boehm.

That said, you can take steps to increase your levels of well-being and optimism about the future; at the very least, you’ll reap the benefits of feeling good. These include nurturing your social relationships, writing down one or two things a day that you’re thankful for, expressing gratitude to others, and engaging in mindfulness meditation.

Deborah Kotz can be reached at dkotz@globe.com. Follow her on Twitter @debkotz2.
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