Perceived Level of Life Enjoyment and Risks of Cardiovascular Disease Incidence and Mortality The Japan Public Health Center–Based Study

• Published in: Circulation (New York, N.Y.) Vol. 120; no. 11; pp. 956 - 963
• Main Authors: Shirai, Kokoro, Iso, Hiroyasu, Ohira, Tetsuya, Ikeda, Ai, Noda, Hiroyuki, Honjo, Kaori, Inoue, Manami, Tsugane, Shoichiro
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 15.09.2009
• Subjects: Adult; Age Distribution; Aged; Asian Continental Ancestry Group - psychology; Asian Continental Ancestry Group - statistics & numerical data; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular Diseases - ethnology; Cardiovascular Diseases - mortality; Cardiovascular Diseases - psychology; Coronary heart disease; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Follow-Up Studies; Happiness; Heart; Humans; Incidence; Japan - epidemiology; Male; Medical sciences; Middle Aged; Multivariate Analysis; Public Health; Quality of Life; Risk Factors; Sex Distribution; Surveys and Questionnaires; Asia; Japan; risk factors; Health center; happiness; Mortality; Risk factor; Cardiovascular disease; cardiovascular diseases; Public health; Incidence
• DOI: 10.1161/CIRCULATIONAHA.108.834176
• ISSN: 0009-7322; 1524-4539

Background— Perceived level of life enjoyment, a positive psychological condition that reflects the ability to engage pleasurably with the environment, may relate to risks of cardiovascular disease. This prospective cohort study attempted to examine the effects of perceived level of life enjoyment on cardiovascular disease incidence and mortality among Japanese community residents. Methods and Results— Subjects were 88 175 Japanese men and women 40 to 69 years of age who were free of cardiovascular disease at baseline and followed up for a median of 12.0 years and were included in the Japan Public Health Center–Based (JPHC) Study Cohort. Data about psychological conditions and other confounding variables were obtained through self-administered questionnaires. Information on incidence and mortality for cardiovascular disease was collected through registered hospitals and public health centers. The multivariable hazard ratios of cardiovascular disease incidence for men in the high versus low perceived levels of life enjoyment group were 1.22 (95% confidence interval, 1.01 to 1.47) for stroke and 1.23 (95% confidence interval, 1.05 to 1.44) for total cardiovascular disease. As for mortality, Japanese men with low perceived level of life enjoyment showed increased risk: hazard ratios of 1.75 (95% confidence interval, 1.28 to 2.38) for stroke, 1.91 (95% confidence interval, 1.30 to 2.81) for coronary heart disease and 1.61 (95% confidence interval, 1.32 to 1.96) for total cardiovascular disease. For women, however, the perceived level of life enjoyment was not associated with risks of cardiovascular disease incidence or mortality. Conclusion— A lower perceived level of life enjoyment was found to be associated with higher risks of cardiovascular disease incidence and mortality among middle-aged men, suggesting a protective role of positive psychological conditions on cardiovascular disease.