New research from the US suggests that having a general sense of well-being, feeling energetic and cheerful, relaxed and happy with life may actually reduce the chances of having a heart attack.

Lisa R. Yanek, assistant professor in Johns Hopkins University School of Medicine’s division of General Internal Medicine, and colleagues report their findings in the July 1st issue of American Journal of Cardiology.

In a statement, Yanek says having a happy disposition can make you healthier because it has an effect on disease.

“If you are by nature a cheerful person and look on the bright side of things, you are more likely to be protected from cardiac events,” she says.

However, being of a cheerful disposition is not necessarily something that can be learned. Yanek warns that it is most likely something you are born with.

Previous studies have suggested that people with a tendency for depression and anxiety have a higher risk for heart attacks and are more likely to die from heart-related problems than people with a sunny disposition.

This latest study is not the first to link heart health to positive emotions.

In 2012, a large systematic review of published studies found that optimism, happiness and other positive emotions may help protect heart health and lower the risk of heart attacks, strokes and other cardiovascular events.

But Yanek and colleagues believe their findings go further because they studied a group already considered to be at high risk for coronary events. The results show that those with higher levels of well-being, while still having many risk factors for heart disease, experience fewer serious cardiac events.

And although the underlying mechanisms that link happiness to heart health remain unclear, the researchers say their findings offer some insights into mind-body connections that, if further explored, will yield important clues as to what the mechanisms might be.

For their study they used data from a Johns Hopkins siblings project that has been going for over 25 years. The project, which is sponsored by the National Institutes of Health (NIH) is called GeneSTAR (Genetic Study of Atherosclerosis Risk), and aims to discover the roots of heart disease in people with a family history of coronary disease.

The data the researchers analyzed came from 1,483 healthy brothers and sisters of people who were diagnosed with coronary disease before the age of 60 and who were followed for 5 to 25 years. Siblings of people who develop coronary artery disease early have twice the risk of developing it themselves.

The participants also completed surveys that included measures of well-being. These included factors such as mood, concern about health, relaxed versus anxious disposition, life satisfaction and energy levels.

The average follow-up was 12 years, during which the researchers counted 208 heart attacks, sudden cardiac deaths, acute coronary syndromes and surgical events, such as stents and bypasses, among the participants.

When Yanek and colleagues analyzed the heart-related events against the well-being measures, they found positive well-being was linked to a one-third reduction in coronary events.

And among participants otherwise considered to have the highest risk for coronary events, this risk was reduced by 50% when linked to positive well-being.

These links persisted when the researchers took out the effect of other influencing factors such as age, diabetes, smoking, high blood pressure and high cholesterol.

The researchers then validated their findings by looking at data on nearly 6,000 people from the general population who took part in the first National Health and Nutrition Examination Survey (NHANES), who were followed for an average of 16 years.

They found that participants with a cheerful disposition had a 13% lower risk of heart attack or other coronary event, regardless of race or sex.

Funds from NIH’s National Institute of Nursing Research, National Heart, Lung, and Blood Institute, and National Center for Research Resources helped finance the study.

Written by Catharine Paddock PhD