Introduction: Positive emotional well-being (PEWB) is defined as high levels of positive affect (PA) and life satisfaction (LS) in the absence of depressive symptoms. The present study examines the relationship between PEWB and several cardiovascular biomarkers: blood pressure, HDL cholesterol, total cholesterol, ratio of total cholesterol to HDL cholesterol, and a composite measure of cardiovascular risk.

Methods: Data were from a nationwide survey of adults (age 18 to 96) who had biomarker data (N= 2295). PA and LS were assessed via self-report questionnaires. Blood pressure was collected in-person according to AHA standards. A bloodspot finger-prick was used to measure HDL and total cholesterol, Hemoglobin A1c (HbA1c), and C-Reactive Protein (CRP). The composite measure of cardiovascular risk included these plus systolic blood pressure (SBP) and diastolic blood pressure (DBP). The mediating role of health behaviors (smoking, alcohol, BMI, and moderate exercise) was also examined.

Results: Regression analysis showed that both PA and LS were significantly negatively related to the composite cardiovascular risk score (PA: β = -.047, t = -3.145, p = .002; LS: β = -.059, t = -2.711, p = .007) and DBP (PA: β = -.167, t= -2.943, p= 0.003; LS: β = -.141, t= -2.433, p= 0.016) when controlling for demographic variables, BMI, depression, and HbA1c. Additionally, PA (but not LS) was significantly related to higher levels of HDL cholesterol. No significant relationships were found between either PA or LS with SBP, total cholesterol, or the ratio of total cholesterol divided by HDL. BMI was the health behavior that most consistently partially mediated the significant relationships between PEWB and cardiovascular risk/biomarkers. Moderate exercise partially mediated the relationship between LS and cardiovascular risk.

Discussion: This study adds to previous literature documenting a significant relationship between PEWB and cardiovascular risk and several related biomarkers. Assessing aspects of individuals’ emotional well-being such as PA and LS may be helpful to gain a better understanding of an individuals’ mental health, quality of life, and cardiovascular risk. Interventions to improve PEWB may be especially beneficial among individuals with high cardiovascular disease risk. Given the cross-sectional design of this study, more longitudinal studies are necessary to understand directionality and mechanisms explaining the observed relationships.