Physiological Pathways Underlying the Association Between Psychological Well-Being and Cardiovascular Health

Psychological well-being is associated with favorable cardiovascular health, but its physiological mechanisms remain incompletely understood. We examined associations between psychological well-being and inflammatory, hemodynamic, and neuroendocrine measures in 846 participants from the community-based Health, Environment, and Action in Louisville study. Well-being was assessed with the Warwick-Edinburgh Mental Well-Being Scale; perceived stress, depressive symptoms, and neighborhood social cohesion were evaluated as complementary psychosocial measures. Primary outcomes were high-sensitivity C-reactive protein (hsCRP), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Multivariable models adjusted for demographic, socioeconomic, and smoking-related factors, with false discovery rate correction. Greater well-being was associated with lower hsCRP (β = −0.12, 95% CI: −0.20 to −0.04; p = 0.002), SBP (β = −2.03 mmHg, 95% CI: −3.16 to −0.90; p < 0.001), and DBP (β = −1.56 mmHg, 95% CI: −2.36 to −0.76; p < 0.001). Perceived stress showed reciprocal associations, whereas depressive symptoms and neighborhood social cohesion were less consistent. Selected urinary catecholamines, but not hair cortisol, were associated with well-being. These findings identify inflammatory and hemodynamic correlates of psychological well-being and support further investigation of positive psychological health in cardiovascular disease prevention.