Positive psychological well-being in adolescence predicts favorable cardiovascular health in early adulthood


Qureshi, Farah; Delaney, Scott; Santos, Kelb Bousquet; Boehm, Julia; & Kubzansky, Laura D. (2018). Positive psychological well-being in adolescence predicts favorable cardiovascular health in early adulthood. 2018 Add Health Users Conference. Bethesda, MD.


Background: Prior work has found that positive psychological well-being (PPWB) (e.g. positive emotions, optimism) predicts a lower likelihood of developing cardiovascular disease. To date, most research has studied well-being at mid-life when cardiovascular health is already on the decline. Few studies have examined prospective relationships at earlier ages when the majority of young people are still in good health. Therefore, this study aimed to evaluate whether PPWB in adolescence predicts a greater likelihood of being in favorable cardiovascular health (FCH) among young adults. Methods: Data are from 14,544 participants in the National Longitudinal Study of Adolescent to Adult Health. Following prior work in Add Health, adolescent PPWB was derived using items from self-report measures of psychological functioning administered at Waves 1 and 2. Responses to individual items were averaged between waves then z-scored and summed to create a continuous PPWB measure that was the primary exposure in all analyses. FCH was assessed at Wave 4 (mean age 29.0 yrs), and defined as being healthy on 5 parameters following American Heart Association recommendations: no hyperlipidemia, diabetes, or high blood pressure, healthy body mass index (BMI), and non-smoking. Parameters were derived from direct measures of cholesterol, glucose, HbA1C, blood pressure, and BMI, and self-reported relevant diagnoses, medication use, and smoking history. FCH was assessed as both a continuous score (range 0-5) and binary measure defined as meeting all 5 parameters (yes/no). After multiply imputing missing covariate and select outcome data, we examined associations between PPWB and total FCH parameters using Poisson regression, controlling for socioeconomic factors at Wave 1, baseline health status, and parental health status. Logistic regressions tested adjusted associations with the binary FCH measure. Results: At Wave 4, only 6% of the sample had FCH. While 64% of participants had low cholesterol, 60% no diabetes, and 64% were non-smokers, only 34% had no hypertension and 32% had a healthy BMI. Youth PPWB predicted subsequent number of FCH components at Wave 4 (RR=0.02, 95% CI=0.01, 0.03), which translated to a 13% greater likelihood of being in good health (OR=1.13, 95% CI=0.98, 1.31). Conclusion: Our findings suggest that adolescent PPWB is health-promoting over time, and therefore may be a promising new target for the primordial prevention of cardiovascular disease.

Reference Type

Conference proceeding

Book Title

2018 Add Health Users Conference


Qureshi, Farah
Delaney, Scott
Santos, Kelb Bousquet
Boehm, Julia
Kubzansky, Laura D.

Year Published


City of Publication

Bethesda, MD

Reference ID