Is flourishing good for the heart? Relationships between positive psychology characteristics and cardiorespiratory health

  • Barna Konkoly Thege
  • Adam D. Tarnoki
  • David L. Tarnoki
  • Zsolt Garami
  • Viktor Berczi
  • Ildiko Horvath
  • Gabor Veress
Keywords: Positive psychology, well-being, cardiovascular indicators, arterial stiffness, lung functions


The purpose of this study was to provide further data on the relationships between positive psychology constructs and cardiorespiratory parameters including arterial stiffness indicators. Hypotheses were tested cross-sectionally on a sample of patients with cardiovascular disease and on a healthy sample. Life satisfaction, psychological well-being, optimism, meaning in life, and sense of coherence were included as psychological indicators, while peripheral and central blood pressure, arterial stiffness, and heart cycle and respiratory function parameters were used as physiological variables. Most of the associations examined were not significant in either sample, with some notable exceptions (the direction of these linear relationships was in accordance with our expectations). Satisfaction with life was related to lower peripheral systolic and mean arterial blood pressure in the clinical sample. Further, sense of coherence was positively associated with forced expiratory volume. In the healthy sample, the augmentation indexes and aortic systolic blood pressure were negatively associated with optimism. However, none of the linear and non-linear relationships proved to be significant in either of the samples when using the Bonferroni correction. Further research should determine whether the present findings derive from the cultural characteristics of our samples or whether the mediators between flourishing and cardiorespiratory health should be sought among other variables than the ones included in the present investigation


Antonovsky, A. (1993). The structure and properties of the Sense of Coherence Scale. Social Science & Medicine, 36(6), 725-733. doi: 10.1016/0277-9536(93)90033-z

Aspinwall, L., & Tedeschi, R. (2010). The value of positive psychology for health psychology: Progress and pitfalls in examining the relation of positive phenomena to health. Annals of Behavioral Medicine, 39(1), 4-15. doi: 10.1007/s12160-009-9153-0

Baulmann, J., Schillings, U., Rickert, S., Uen, S., Düsing, R., Illyes, M., et al. (2008). A new oscillometric method for assessment of arterial stiffness: comparison with tonometric and piezo-electronic methods. Journal of Hypertension, 26(3), 523-528. doi: 10.1097/HJH.0b013e3282f314f7

Bech, P., Gudex, C., & Johansen, K.S. (1996). The WHO (ten) Well-Being Index: Validation in diabetes. Psychotherapy and Psychosomatics, 65(4), 183-190. doi: 10.1159/000289073

Bech, P., Olsen, L.R., Kjoller, M., & Rasmussen, N.K. (2003). Measuring well-being rather than the absence of distress symptoms: a comparison of the SF-36 Mental Health subscale and the WHO-Five well-being scale. International Journal of Methods in Psychiatric Research, 12(2), 85-91. doi: 10.1002/mpr.145

Bérdi, M., & Köteles, F. (2010). Az optimizmus mérése: az Életszemlélet Teszt átdolgozott változatának (LOT–R) pszichometriai jellemzői hazai mintán [The measurement of optimism: the psychometric properties of the Hungarian version of the Revised Life Orientation Test (LOT–R) ]. Magyar Pszichológiai Szemle, 65(2), 273-294. doi: 10.1556/MPSzle.65.2010.2.7

Bhattacharyya, M.R., Whitehead, D.L., Rakhit, R., & Steptoe, A. (2008). Depressed mood, positive affect, and heart rate variability in patients with suspected coronary artery disease. Psychosomatic Medicine, 70(9), 1020-1027. doi: 10.1097/PSY.0b013e318189afcc

Boehm, J.K., & Kubzansky, L.D. (2012). The heart's content: The association between positive psychological well-being and cardiovascular health. Psychological Bulletin, 138(4), 655-691. doi: 10.1037/a0027448

Boehm, J.K., Peterson, C., Kivimaki, M., & Kubzansky, L. (2011a). A prospective study of positive psychological well-being and coronary heart disease. Health Psychology, 30(3), 259-267. doi: 10.1037/a0023124

Boehm, J.K., Peterson, C., Kivimaki, M., & Kubzansky, L.D. (2011b). Heart health when life is satisfying: evidence from the Whitehall II cohort study. European Heart Journal, 32(21), 2672-2677. doi: 10.1093/eurheartj/ehr203

Boehm, J.K., Williams, D.R., Rimm, E.B., Ryff, C., & Kubzansky, L.D. (2013). Association between optimism and serum antioxidants in the Midlife in the United States Study. Psychosomatic Medicine, 75(1), 2-10. doi: 10.1097/PSY.0b013e31827c08a9

Brodskaia, T.A., Gel'tser, B.I., Nevzorova, V.A., & Motkina, E.V. (2007). [Clinico-functional evaluation of arterial rigidity in bronchial asthma]. Kliničeskaâ Medicina, 85(6), 31-36.

Buist, A.S. (1987). Standardization of spirometry — 1987 update. American Journal of Respiratory and Critical Care Medicine, 136(5), 1073-1074. doi: 10.1164/ajrccm/136.5.1073

Chida, Y., & Steptoe, A. (2008). Positive psychological well-being and mortality: A quantitative review of prospective observational studies. Psychosomatic Medicine, 70(7), 741-756. doi: 10.1097/PSY.0b013e31818105ba

Diener, E., Emmons, R.A., Larsen, R.J., & Griffin, S. (1985). The Satisfaction With Life Scale. Journal of Personality Assessment, 49(1), 71-75. doi: 10.1207/s15327752jpa4901_13

DuBois, C.M., Beach, S.R., Kashdan, T.B., Nyer, M.B., Park, E.R., Celano, C.M., et al. (2012). Positive psychological attributes and cardiac outcomes: associations, mechanisms, and interventions. Psychosomatics, 53(4), 303-318.

Eriksson, M., & Lindström, B. (2005). Validity of Antonovsky’s Sense of Coherence Scale: a systematic review. Journal of Epidemiology and Community Health, 59(6), 460-466. doi: 10.1136/jech.2003.018085

Eriksson, M., & Lindström, B. (2006). Antonovsky’s Sense of Coherence Scale and the relation with health: A systematic review. Journal of Epidemiology and Community Health, 60(5), 376-381. doi: 10.1136/jech.2005.041616

Franklin, S.S. (2004). Pulse pressure as a risk factor. Clinical and Experimental Hypertension, 26(7-8), 645-652. doi: doi:10.1081/CEH-200031962

Giltay, E.J., Geleijnse, J.M., Zitman, F.G., Hoekstra, T., & Schouten, E.G. (2004). Dispositional optimism and all-cause and cardiovascular mortality in a prospective cohort of elderly Dutch men and women. Arch Gen Psychiatry, 61(11), 1126-1135. doi: 10.1001/archpsyc.61.11.1126

Glaesmer, H., Hoyer, J., Klotsche, J., & Herzberg, P.Y. (2008). Die deutsche Version des Life-Orientation-Tests (LOT-R) zum dispositionellen Optimismus und Pessimismus. Zeitschrift für Gesundheitspsychologie, 16(1), 26-31. doi: 10.1026/0943-8149.16.1.26

Grant, A.M., & Schwartz, B. (2011). Too much of a good thing: The challenge and opportunity of the inverted U. Perspectives on Psychological Science, 6(1), 61-76. doi: 10.1177/1745691610393523

Jeges, S., & Varga, K. (2006). Unravelling the mystery of the sense of coherence. European Journal of Mental Health, 1(1), 45-71. doi: 10.1556/EJMH.1.2006.1-2.3

Konkolÿ Thege, B., Martos, T., Skrabski, Á., & Kopp, M. (2008). A Rövidített Stressz és Megküzdés Kérdőív élet értelmességét mérő alskálájának (BSCI-LM) pszichometriai jellemzői [Psychometric properties of the Life Meaning Subscale from the Brief Stress and Coping Inventory (BSCI-LM)]. Mentálhigiéné es Pszichoszomatika, 9(3), 243-261. doi: 10.1556/Mental.9.2008.3.4

Krause, N. (2004). Stressors arising in highly valued roles, meaning in life, and the physical health status of older adults. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 59(5), S287-S297. doi: 10.1093/geronb/59.5.S287

Krause, N. (2009). Meaning in life and mortality. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 64B(4), 517-527. doi: 10.1093/geronb/gbp047

Kubzansky, L.D., & Adler, G.K. (2010). Aldosterone: A forgotten mediator of the relationship between psychological stress and heart disease. Neuroscience and Biobehavioral Reviews, 34(1), 80-86. doi: 10.1016/j.neubiorev.2009.07.005

London, G.M., Blacher, J., Pannier, B., Guérin, A.P., Marchais, S.J., & Safar, M.E. (2001). Arterial wave reflections and survival in end-stage renal failure. Hypertension, 38(3), 434-438. doi: 10.1161/01.hyp.38.3.434

Löwe, B., Gräfe, K., Zipfel, S., Witte, S., Loerch, B., & Herzog, W. (2004). Diagnosing ICD-10 depressive episodes: Superior criterion validity of the Patient Health Questionnaire. Psychotherapy and Psychosomatics, 73(6), 386-390. doi: 10.1159/000080393

Lusuardi, M., De Benedetto, F., Paggiaro, P., Sanguinetti, C.M., Brazzola, G., Ferri, P., et al. (2006). A randomized controlled trial on office spirometry in asthma and COPD in standard general practice. Chest, 129(4), 844-852. doi: 10.1378/chest.129.4.844

Matthews, K.A., Owens, J.F., Edmundowicz, D., Lee, L., & Kuller, L.H. (2006). Positive and negative attributes and risk for coronary and aortic calcification in healthy women. Psychosomatic Medicine, 68(3), 355-361. doi: 10.1097/01.psy.0000221274.21709.d0

Matthews, K.A., Räikkönen, K., Sutton-Tyrrell, K., & Kuller, L.H. (2004). Optimistic attitudes protect against progression of carotid atherosclerosis in healthy middle-aged women. Psychosomatic Medicine, 66(5), 640-644. doi: 10.1097/01.psy.0000139999.99756.a5

Mezick, E.J., Matthews, K.A., Hall, M., Kamarck, T.W., Strollo, P.J., Buysse, D.J., et al. (2010). Low life purpose and high hostility are related to an attenuated decline in nocturnal blood pressure. Health Psychology, 29(2), 196-204. doi: 10.1037/a0017790

Milam, J.E., Richardson, J.L., Marks, G., Kemper, C.A., & McCutchan, A.J. (2004). The roles of dispositional optimism and pessimism in HIV disease progression. Psychology & Health, 19(2), 167-181. doi: 10.1080/08870440310001652696

Myrtek, M., Aschenbrenner, E., & Brügner, G. (2005). Emotions in everyday life: an ambulatory monitoring study with female students. Biological Psychology, 68(3), 237-255. doi:

Nakagawa, S. (2004). A farewell to Bonferroni: the problems of low statistical power and publication bias. Behavioral Ecology, 15(6), 1044-1045. doi: 10.1093/beheco/arh107

Nasermoaddeli, A., Sekine, M., & Kagamimori, S. (2006). Gender differences in associations of C-reactive protein with atherosclerotic risk factors and psychosocial characteristics in Japanese civil servants. Psychosomatic Medicine, 68(1), 58-63. doi: 10.1097/01.psy.0000195882.00407.05

Rahe, R.H., & Tolles, R.L. (2002). The Brief Stress and Coping Inventory: A useful stress management instrument. International Journal of Stress Management, 9(2), 61-70. doi: 10.1023/a:1014950618756

Räikkönen, K., & Matthews, K.A. (2008). Do dispositional pessimism and optimism predict ambulatory blood pressure during schooldays and nights in adolescents? Journal of Personality, 76(3), 605-630. doi: 10.1111/j.1467-6494.2008.00498.x

Räikkönen, K., Matthews, K.A., Flory, J.D., Owens, J.F., & Gump, B.B. (1999). Effects of optimism, pessimism, and trait anxiety on ambulatory blood pressure and mood during everyday life. Journal of Personality and Social Psychology, 76(1), 104-113.

Roman, M.J., Devereux, R.B., Kizer, J.R., Lee, E.T., Galloway, J.M., Ali, T., et al. (2007). Central pressure more strongly relates to vascular disease and outcome than does brachial pressure. Hypertension, 50(1), 197-203. doi: 10.1161/hypertensionaha.107.089078

Roman, M.J., Okin, P.M., Kizer, J.R., Lee, E.T., Howard, B.V., & Devereux, R.B. (2010). Relations of central and brachial blood pressure to left ventricular hypertrophy and geometry: the Strong Heart Study. Journal of Hypertension, 28(2), 384-388. doi: 10.1097/HJH.0b013e328333d228

Ryan, R.M., & Deci, E.L. (2001). On happiness and human potentials: a review of research on hedonic and eudaimonic well-being. Annual Review of Psychology, 52, 141-166.

Ryff, C.D., Dienberg Love, G., Urry, H.L., Muller, D., Rosenkranz, M.A., Friedman, E.M., et al. (2006). Psychological well-being and ill-being: do they have distinct or mirrored biological correlates? Psychotherapy and Psychosomatics, 75(2), 85-95.

Scheier, M.F., Carver, C.S., & Bridges, M.W. (1994). Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A reevaluation of the Life Orientation Test. Journal of Personality and Social Psychology, 67(6), 1063-1078. doi: 10.1037/0022-3514.67.6.1063

Schmidt, C.K., Raque-Bogdan, T.L., Piontkowski, S., & Schaefer, K.L. (2011). Putting the positive in health psychology: A content analysis of three journals. Journal of Health Psychology, 16(4), 607-620. doi: 10.1177/1359105310384296

Schroeder, E.B., Welch, V.L., Couper, D., Nieto, F.J., Liao, D., Rosamond, W.D., et al. (2003). Lung function and incident coronary heart disease. American Journal of Epidemiology, 158(12), 1171-1181. doi: 10.1093/aje/kwg276

Segerstrom, S.C., Taylor, S.E., Kemeny, M.E., & Fahey, J.L. (1998). Optimism is associated with mood, coping, and immune change in response to stress. Journal of Personality and Social Psychology, 74(6), 1646-1655. doi: 10.1037/0022-3514.74.6.1646

Seki, N. (2001). [Relationships between walking hours, sleeping hours, meaningfulness of life (ikigai) and mortality in the elderly: prospective cohort study]. Nippon Eiseigaku Zasshi, 56(2), 535-540.

Seligman, M.E., & Csikszentmihalyi, M. (2000). Positive psychology. An introduction. American Psychologist, 55(1), 5-14. doi: 10.1037/0003-066X.55.1.5

Sheldon, K.M., & King, L. (2001). Why positive psychology is necessary. American Psychologist, 56(3), 216-217. doi: 10.1037/0003-066X.56.3.216

Skrabski, Á., Kopp, M., Rózsa, S., Réthelyi, J., & Rahe, R. (2005). Life meaning: an important correlate of health in the Hungarian population. International Journal of Behavioral Medicine, 12(2), 78-85. doi: 10.1207/s15327558ijbm1202_5

Sone, T., Nakaya, N., Ohmori, K., Shimazu, T., Higashiguchi, M., Kakizaki, M., et al. (2008). Sense of life worth living (ikigai) and mortality in Japan: Ohsaki Study. Psychosomatic Medicine, 70(6), 709-715. doi: 10.1097/PSY.0b013e31817e7e64

Steptoe, A., Demakakos, P., de Oliveira, C., & Wardle, J. (2012). Distinctive biological correlates of positive psychological well-being in older men and women. Psychosomatic Medicine, 74(5), 501-508. doi: 10.1097/PSY.0b013e31824f82c8

Surtees, P., Wainwright, N., Luben, R., Khaw, K.-T., & Day, N. (2003). Sense of coherence and mortality in men and women in the EPIC-Norfolk United Kingdom Prospective Cohort Study. American Journal of Epidemiology, 158(12), 1202-1209. doi: 10.1093/aje/kwg272

Susánszky, É., Konkoly Thege, B., Stauder, A., & Kopp, M. (2006). A WHO Jól-lét Kérdőív rövidített (WBI-5) magyar változatának validálása a Hungarostudy 2002 országos lakossági egészségfelmérés alapján [Validation of the short (5-item) version of the WHO well-being scale based on a Hungarian representative health survey (Hungarostudy 2002)]. Mentálhigiéné es Pszichoszomatika, 7(3), 247-255. doi: 10.1556/Mental.7.2006.3.8

Tindle, H.A., Chang, Y.-F., Kuller, L.H., Manson, J.E., Robinson, J.G., Rosal, M.C., et al. (2009). Optimism, cynical hostility, and incident coronary heart disease and mortality in the Women’s Health Initiative. Circulation, 120(8), 656-662. doi: 10.1161/circulationaha.108.827642

Tóth, M.D., & Kovács, J. (2011). „Magyar kesergő” — otthon és külföldön tanuló magyar és nem magyar egyetemisták optimizmusának és szubjektív jóllétének összevetése [„Hungarian moaner” - comparing optimism and subjective well-being among Hungarian and foreign university students studying at home and abroad]. Mentálhigiéné es Pszichoszomatika, 12(4), 277-298. doi: 10.1556/Mental.12.2011.4.1

Wang, K.L., Cheng, H.M., Chuang, S.Y., Spurgeon, H.A., Ting, C.T., Lakatta, E.G., et al. (2009). Central or peripheral systolic or pulse pressure: which best relates to target organs and future mortality? Journal of Hypertension, 27(3), 461-467. doi: 10.1097/HJH.0b013e3283220ea4

World Health Organization (2008). The top 10 causes of death. Retrieved 28.12.2011, from

How to Cite
Konkoly Thege, B., Tarnoki, A., Tarnoki, D., Garami, Z., Berczi, V., Horvath, I., & Veress, G. (2014). Is flourishing good for the heart? Relationships between positive psychology characteristics and cardiorespiratory health. Anales De Psicología / Annals of Psychology, 31(1), 55-65.
Clinical and Health Psychology