Enhancing Well-Being: Promising Strategy for CVD Prevention, UK Biobank Study Reveals

The study, published in the Journal of the American Heart Association, revealed a strong connection between individual well-being and cardiovascular health, suggesting that enhancing mental and emotional well-being could be a promising strategy for preventing cardiovascular diseases (CVDs).

"The impact of lifestyle factors and inflammation as a mediator offers valuable insights into the biological pathways that may connect psychological states with cardiovascular health," the researchers wrote.

Cardiovascular diseases are the leading cause of global death and disability, intensified by demographic shifts and unhealthy lifestyles. As primary prevention becomes crucial, well-being emerges as a key factor influencing cardiovascular health. Understanding its relationship with inflammation and lifestyle factors can guide more effective interventions.

Recent evidence indicates that well-being may play a protective role in lowering the risk of cardiovascular disease. Considering this, Wen Sun, The First Affiliated Hospital of USTC University of Science and Technology of China Hefei Anhui China, and colleagues aimed to explore the intricate relationship between well-being and CVDs, hypothesizing that this connection may be mediated by healthier lifestyle choices and reduced systemic inflammation.

The objective was to clarify this relationship using Cox proportional hazards models and Mendelian randomization (MR) to examine longitudinal and causal links. Additionally, we investigated lifestyle patterns related to well-being and potential biomarker pathways linking well-being to CVDs.

For this purpose, the researchers conducted a cohort analysis using data from the UK Biobank, which included 121,317 participants. They assessed participants' well-being through a well-being index derived from baseline questionnaires, categorizing well-being using latent class analysis based on general happiness and satisfaction with family, friendships, health, and finances.

The relationship between well-being and four major CVDs was analyzed through Cox proportional hazards models and Mendelian randomization. Additionally, the study explored how well-being influences lifestyle factors and inflammatory markers, examining its mediating role in the connection between well-being and CVDs.

The study led to the following findings:

• Higher well‐being was associated with a significantly reduced risk of various CVDs.
• The latent class analysis identified four distinct well‐being groups (low, variable, moderate‐to‐high, and high satisfaction), with higher satisfaction levels generally associated with a lower risk of CVDs.
• Mendelian randomization suggested potential causal relationships between well‐being and reduced risk of CVDs.
• Participants with greater well‐being demonstrated healthier behaviors and lower levels of inflammatory markers.
• Mediation analysis indicated that lifestyle and inflammatory markers partially mediated the relationship between well‐being and CVDs.

The investigation into the relationship between well-being and CVDs (coronary heart disease, myocardial infarction, heart failure, and stroke) demonstrates a robust inverse association. Higher levels of well-being correlate with a decreased risk of various CVDs, a relationship that remains significant even after controlling for potential confounding factors, including healthy lifestyle choices and blood inflammatory markers. Mediation analysis further reveals that the protective effect of well-being on CVDs is partially mediated by enhancements in healthy lifestyle habits and reductions in systemic inflammation.

"These findings highlight the importance of integrating well-being enhancement strategies into public health initiatives to mitigate CVD risk," the researchers concluded.

Reference:

Zhong J, Zhang P, Dong Y, et al. Well-being and cardiovascular health: insights from the UK Biobank Study. J Am Heart Assoc. 2024;13:e035225.