{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:33:43Z","timestamp":1791318823304,"version":"4.3.1"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T00:00:00Z","timestamp":1743984000000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HL071981, HL034594, HL126024"],"award-info":[{"award-number":["HL071981, HL034594, HL126024"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["DK115679, DK091718, DK100383, DK078616"],"award-info":[{"award-number":["DK115679, DK091718, DK100383, DK078616"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Epidemiol"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Emerging evidence suggests a role of psychological well-being in the development of cardiovascular disease (CVD), but supportive data remain limited. This study assessed the prospective associations between life satisfaction and incident CVD, as well as the relative importance of life satisfaction compared to traditional risk factors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>The study included 153,810 participants free of CVD at baseline, with measurements of life satisfaction on general happiness, personal health, family relationships, friendships, and financial situation, followed up until December 31, 2022. Cox proportional hazards models were used to estimate associations between life satisfaction and incident CVD. The relative importance of life satisfaction in predicting CVD was measured by explained R<jats:sup>2<\/jats:sup> values.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>During a median follow-up of 12.9 years, 14,370 incident CVD events occurred, including 10,070 CHD and 2,895 strokes. Individuals with low life satisfaction had an 80% higher risk of CVD compared to those with high life satisfaction (hazard ratio [95% confidence interval], 1.84 [1.63\u20132.07] for CVD, 1.83 [1.59\u20132.10] for CHD, and 1.74 [1.31\u20132.31] for stroke). Life satisfaction was ranked as the fourth-strongest CVD risk factor, following hypertension, race, and income. Low satisfaction with all individual aspects was significantly associated with higher risks of CVD and CHD (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05), while satisfaction with personal health showing the strongest association.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>This study indicates that life satisfaction is robustly associated with incident CVD and may be considered one of the strongest predictors of CVD risk, alongside traditional risk factors. Our findings support the inclusion of life satisfaction in cardiovascular health metrics.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s10654-025-01225-w","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T10:06:08Z","timestamp":1744106768000},"page":"441-449","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Life satisfaction as compared with traditional risk factors in relation to incident cardiovascular diseases"],"prefix":"10.1007","volume":"40","author":[{"given":"Minghao","family":"Kou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoriko","family":"Heianza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JoAnn E.","family":"Manson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6637-6428","authenticated-orcid":false,"given":"Lu","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,7]]},"reference":[{"key":"1225_CR1","doi-asserted-by":"publisher","unstructured":"Global regional. and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet (London, England). Nov 10 2018;392(10159):1736\u20131788. https:\/\/doi.org\/10.1016\/s0140-6736(18)32203-7","DOI":"10.1016\/s0140-6736(18)32203-7"},{"issue":"5","key":"1225_CR2","doi-asserted-by":"publisher","first-page":"e18","DOI":"10.1161\/CIR.0000000000001078","volume":"146","author":"DM Lloyd-Jones","year":"2022","unstructured":"Lloyd-Jones DM, Allen NB, Anderson CAM, et al. Life\u2019s essential 8: updating and enhancing the American heart association\u2019s construct of cardiovascular health: A presidential advisory from the American heart association. Circulation. 2022;146(5):e18\u201343. https:\/\/doi.org\/10.1161\/CIR.0000000000001078.","journal-title":"Circulation"},{"issue":"10","key":"1225_CR3","doi-asserted-by":"publisher","first-page":"e763","DOI":"10.1161\/CIR.0000000000000947","volume":"143","author":"GN Levine","year":"2021","unstructured":"Levine GN, Cohen BE, Commodore-Mensah Y, et al. Psychological health, Well-Being, and the Mind-Heart-Body connection: A scientific statement from the American heart association. Circulation. 2021;143(10):e763\u201383. https:\/\/doi.org\/10.1161\/CIR.0000000000000947.","journal-title":"Circulation"},{"key":"1225_CR4","doi-asserted-by":"crossref","unstructured":"Maddux JE. Subjective well-being and life satisfaction: an introduction to conceptions, theories, and measures. Subjective well-being and life satisfaction. Routledge\/Taylor & Francis Group; 2018. pp. 3\u201331.","DOI":"10.4324\/9781351231879-1"},{"key":"1225_CR5","doi-asserted-by":"crossref","unstructured":"Diener E. The science of well-being: the collected works of ed diener. Volume 37. Springer; 2009.","DOI":"10.1007\/978-90-481-2350-6"},{"issue":"9","key":"1225_CR6","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1007\/s12603-012-0404-6","volume":"16","author":"KA Wickrama","year":"2012","unstructured":"Wickrama KA, Ralston PA, O\u2019Neal CW, et al. Life dissatisfaction and eating behaviors among older African Americans: the protective role of social support. J Nutr Health Aging. 2012;16(9):749\u201353. https:\/\/doi.org\/10.1007\/s12603-012-0404-6.","journal-title":"J Nutr Health Aging"},{"issue":"3","key":"1225_CR7","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1007\/s10865-017-9909-0","volume":"41","author":"YP Mendez","year":"2018","unstructured":"Mendez YP, Ralston PA, Wickrama K, Bae D, Young-Clark I, Ilich JZ. Lower life satisfaction, active coping and cardiovascular disease risk factors in older African Americans: outcomes of a longitudinal church-based intervention. J Behav Med Jun. 2018;41(3):344\u201356. https:\/\/doi.org\/10.1007\/s10865-017-9909-0.","journal-title":"J Behav Med Jun"},{"key":"1225_CR8","doi-asserted-by":"publisher","unstructured":"Natt och Dag Y, Engstr\u00f6m G, Rosvall M. Life satisfaction and coronary atherosclerosis: The SCAPIS study. Journal of Psychosomatic Research. 2022\/01\/01\/ 2022;152:110663. doi:https:\/\/doi.org\/10.1016\/j.jpsychores.2021.110663.","DOI":"10.1016\/j.jpsychores.2021.110663."},{"key":"1225_CR9","doi-asserted-by":"publisher","first-page":"101635","DOI":"10.1016\/j.pmedr.2021.101635","volume":"2021\/12\/01","author":"S Stenlund","year":"2021","unstructured":"Stenlund S, Koivumaa-Honkanen H, Sillanm\u00e4ki L, Lagstr\u00f6m H, Rautava P, Suominen S. Subjective well-being predicts health behavior in a population-based 9-years follow-up of working-aged Finns. Prev Med Rep. 2021;2021\/12\/01:24:101635. https:\/\/doi.org\/10.1016\/j.pmedr.2021.101635.","journal-title":"Prev Med Rep"},{"issue":"11","key":"1225_CR10","doi-asserted-by":"publisher","first-page":"1820","DOI":"10.1017\/s0033291719001879","volume":"50","author":"L Poole","year":"2020","unstructured":"Poole L, Hackett RA, Panagi L, Steptoe A. Subjective wellbeing as a determinant of glycated hemoglobin in older adults: longitudinal findings from the english longitudinal study of ageing. Psychol Med Aug. 2020;50(11):1820\u20138. https:\/\/doi.org\/10.1017\/s0033291719001879.","journal-title":"Psychol Med Aug"},{"issue":"10","key":"1225_CR11","doi-asserted-by":"publisher","first-page":"2207","DOI":"10.1177\/1359105315572455","volume":"21","author":"M Jackowska","year":"2016","unstructured":"Jackowska M, Brown J, Ronaldson A, Steptoe A. The impact of a brief gratitude intervention on subjective well-being, biology and sleep. J Health Psychol Oct. 2016;21(10):2207\u201317. https:\/\/doi.org\/10.1177\/1359105315572455.","journal-title":"J Health Psychol Oct"},{"issue":"21","key":"1225_CR12","doi-asserted-by":"publisher","first-page":"2672","DOI":"10.1093\/eurheartj\/ehr203","volume":"32","author":"JK Boehm","year":"2011","unstructured":"Boehm JK, Peterson C, Kivimaki M, Kubzansky LD. Heart health when life is satisfying: evidence from the Whitehall II cohort study. Eur Heart J Nov. 2011;32(21):2672\u20137. https:\/\/doi.org\/10.1093\/eurheartj\/ehr203.","journal-title":"Eur Heart J Nov"},{"issue":"2","key":"1225_CR13","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1080\/16501970306119","volume":"35","author":"R Melin","year":"2003","unstructured":"Melin R, Fugl-Meyer KS, Fugl-Meyer AR. Life satisfaction in 18- to 64-year-old Swedes: in relation to education, employment situation, health and physical activity. J Rehabilitation Med Mar. 2003;35(2):84\u201390. https:\/\/doi.org\/10.1080\/16501970306119.","journal-title":"J Rehabilitation Med Mar"},{"key":"1225_CR14","doi-asserted-by":"publisher","unstructured":"Schimmack U, Krause P, Wagner GG, Schupp J. Stability and Change of Well Being: An Experimentally Enhanced Latent State-Trait-Error Analysis. Social Indicators Research. 2010\/01\/01 2010;95(1):19\u201331. https:\/\/doi.org\/10.1007\/s11205-009-9443-8","DOI":"10.1007\/s11205-009-9443-8"},{"issue":"8","key":"1225_CR15","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1001\/jamacardio.2018.1717","volume":"3","author":"MA Said","year":"2018","unstructured":"Said MA, Verweij N, van der Harst P. Associations of combined genetic and lifestyle risks with incident cardiovascular disease and diabetes in the UK biobank study. JAMA Cardiol. 2018;3(8):693\u2013702. https:\/\/doi.org\/10.1001\/jamacardio.2018.1717.","journal-title":"JAMA Cardiol"},{"issue":"6","key":"1225_CR16","doi-asserted-by":"publisher","first-page":"e697","DOI":"10.1212\/wnl.0000000000009924","volume":"95","author":"K Rannikm\u00e4e","year":"2020","unstructured":"Rannikm\u00e4e K, Ngoh K, Bush K, et al. Accuracy of identifying incident stroke cases from linked health care data in UK biobank. Neurology. 2020;95(6):e697\u2013707. https:\/\/doi.org\/10.1212\/wnl.0000000000009924.","journal-title":"Neurology"},{"key":"1225_CR17","doi-asserted-by":"publisher","first-page":"f2350","DOI":"10.1136\/bmj.f2350","volume":"346","author":"E Herrett","year":"2013","unstructured":"Herrett E, Shah AD, Boggon R, et al. Completeness and diagnostic validity of recording acute myocardial infarction events in primary care, hospital care, disease registry, and National mortality records: cohort study. BMJ: Br Med J. 2013;346:f2350. https:\/\/doi.org\/10.1136\/bmj.f2350.","journal-title":"BMJ: Br Med J"},{"key":"1225_CR18","unstructured":"Brand JPL, Development. Implementation and Evaluation of Multiple Imputation Strategies for the Statistical Analysis of Incomplete Data Sets. 1999."},{"issue":"3","key":"1225_CR19","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1177\/0962280206074463","volume":"16","author":"S van Buuren","year":"2007","unstructured":"van Buuren S. Multiple imputation of discrete and continuous data by fully conditional specification. Stat Methods Med Res Jun. 2007;16(3):219\u201342. https:\/\/doi.org\/10.1177\/0962280206074463.","journal-title":"Stat Methods Med Res Jun"},{"key":"1225_CR20","unstructured":"Venkatraman E, Seshan KW. clinfun: Clinical Trial Design and Data Analysis Functions. 2023. https:\/\/CRAN.R-project.org\/package=clinfun"},{"issue":"2","key":"1225_CR21","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1093\/biostatistics\/kxr047","volume":"13","author":"G Heller","year":"2012","unstructured":"Heller G. A measure of explained risk in the proportional hazards model. Biostatistics (Oxford England) Apr. 2012;13(2):315\u201325. https:\/\/doi.org\/10.1093\/biostatistics\/kxr047.","journal-title":"Biostatistics (Oxford England) Apr"},{"key":"1225_CR22","doi-asserted-by":"publisher","unstructured":"Cooper H, Okamura L, Gurka V. Social activity and subjective well-being. Personality and Individual Differences. 1992\/05\/01\/ 1992;13(5):573\u2013583. https:\/\/doi.org\/10.1016\/0191-8869(92)90198-X","DOI":"10.1016\/0191-8869(92)90198-X"},{"issue":"2","key":"1225_CR23","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1007\/s11205-013-0361-4","volume":"1","author":"KL Siedlecki","year":"2014","unstructured":"Siedlecki KL, Salthouse TA, Oishi S, Jeswani S. The relationship between social support and subjective Well-Being across age. Soc Indic Res Jun. 2014;1(2):561\u201376. https:\/\/doi.org\/10.1007\/s11205-013-0361-4.","journal-title":"Soc Indic Res Jun"},{"issue":"4","key":"1225_CR24","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1080\/17437199.2020.1760728","volume":"15","author":"S Buecker","year":"2021","unstructured":"Buecker S, Simacek T, Ingwersen B, Terwiel S, Simonsmeier BA. Physical activity and subjective well-being in healthy individuals: a meta-analytic review. Health Psychol Rev Dec. 2021;15(4):574\u201392. https:\/\/doi.org\/10.1080\/17437199.2020.1760728.","journal-title":"Health Psychol Rev Dec"},{"key":"1225_CR25","doi-asserted-by":"publisher","unstructured":"Klussman K, Nichols AL, Langer J, Curtin N, Lindeman MIH. The Relationship between Mindfulness and Subjective Well-Being: Examining the Indirect Effects of Self-Connection and Meaning in Life. Applied Research in Quality of Life. 2022\/08\/01 2022;17(4):2423\u20132443. https:\/\/doi.org\/10.1007\/s11482-021-10025-9","DOI":"10.1007\/s11482-021-10025-9"},{"issue":"28","key":"1225_CR26","doi-asserted-by":"publisher","first-page":"2583","DOI":"10.1093\/eurheartj\/ehad306","volume":"44","author":"X Wang","year":"2023","unstructured":"Wang X, Ma H, Li X, Heianza Y, Fonseca V, Qi L. Joint association of loneliness and traditional risk factor control and incident cardiovascular disease in diabetes patients. Eur Heart J. 2023;44(28):2583\u201391. https:\/\/doi.org\/10.1093\/eurheartj\/ehad306.","journal-title":"Eur Heart J"},{"issue":"7","key":"1225_CR27","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1056\/NEJMoa1800256","volume":"16","author":"A Rawshani","year":"2018","unstructured":"Rawshani A, Rawshani A, Franz\u00e9n S, et al. Risk factors, mortality, and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med Aug. 2018;16(7):633\u201344. https:\/\/doi.org\/10.1056\/NEJMoa1800256.","journal-title":"N Engl J Med Aug"},{"issue":"11","key":"1225_CR28","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1002\/clc.20501","volume":"32","author":"Y Gong","year":"2009","unstructured":"Gong Y, Handberg EM, Gerhard T, et al. Systolic blood pressure and subjective well-being in patients with coronary artery disease. Clin Cardiol Nov. 2009;32(11):627\u201332. https:\/\/doi.org\/10.1002\/clc.20501.","journal-title":"Clin Cardiol Nov"},{"key":"1225_CR29","doi-asserted-by":"publisher","first-page":"k3788","DOI":"10.1136\/bmj.k3788","volume":"362","author":"RE Wootton","year":"2018","unstructured":"Wootton RE, Lawn RB, Millard LAC, et al. Evaluation of the causal effects between subjective wellbeing and cardiometabolic health: Mendelian randomisation study. BMJ. 2018;362:k3788. https:\/\/doi.org\/10.1136\/bmj.k3788.","journal-title":"BMJ"},{"key":"1225_CR30","doi-asserted-by":"publisher","unstructured":"White MP, Alcock I, Grellier J et al. Spending at least 120 minutes a week in nature is associated with good health and wellbeing. Scientific Reports. 2019\/06\/13 2019;9(1):7730. https:\/\/doi.org\/10.1038\/s41598-019-44097-3","DOI":"10.1038\/s41598-019-44097-3"},{"issue":"23 Pt B","key":"1225_CR31","doi-asserted-by":"publisher","first-page":"3012","DOI":"10.1016\/j.jacc.2018.10.023","volume":"11","author":"LD Kubzansky","year":"2018","unstructured":"Kubzansky LD, Huffman JC, Boehm JK, et al. Reprint of: positive psychological Well-Being and cardiovascular disease: JACC health promotion series. J Am Coll Cardiol Dec. 2018;11(23 Pt B):3012\u201326. https:\/\/doi.org\/10.1016\/j.jacc.2018.10.023.","journal-title":"J Am Coll Cardiol Dec"},{"issue":"5","key":"1225_CR32","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1080\/13607863.2015.1023766","volume":"20","author":"S Read","year":"2016","unstructured":"Read S, Grundy E, Foverskov E. Socio-economic position and subjective health and well-being among older people in Europe: a systematic narrative review. Aging Ment Health. 2016;20(5):529\u201342. https:\/\/doi.org\/10.1080\/13607863.2015.1023766.","journal-title":"Aging Ment Health"},{"issue":"1","key":"1225_CR33","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1257\/089533006776526030","volume":"20","author":"D Kahneman","year":"2006","unstructured":"Kahneman D, Krueger AB. Developments in the measurement of subjective Well-Being. J Economic Perspect. 2006;20(1):3\u201324. https:\/\/doi.org\/10.1257\/089533006776526030.","journal-title":"J Economic Perspect"}],"container-title":["European Journal of Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10654-025-01225-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10654-025-01225-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10654-025-01225-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,7]],"date-time":"2025-06-07T08:01:28Z","timestamp":1749283288000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10654-025-01225-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":33,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["1225"],"URL":"https:\/\/doi.org\/10.1007\/s10654-025-01225-w","relation":{},"ISSN":["0393-2990","1573-7284"],"issn-type":[{"value":"0393-2990","type":"print"},{"value":"1573-7284","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"26 July 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 April 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All authors have reported that they have no relationships relevant to the contents of this paper to disclose.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}}]}}