Simple psychological practices such as mindfulness meditation, gratitude journaling and optimism training may improve several markers of cardiovascular health within a matter of weeks, according to a new review of clinical trial evidence.
Researchers found that these positive psychology interventions were consistently associated with improvements in blood pressure, inflammation and other risk factors linked to heart disease. Some of the benefits appeared to be connected with healthier behaviours, including improved eating habits and increased physical activity, though the study authors said continued reinforcement may be necessary to sustain progress over time.
The research was led by Rosalba (Rose) Hernandez, a professor of social work at the University of Illinois Urbana-Champaign and a Fellow of the American Heart Association. Her team reviewed results from 18 randomised controlled trials that tested positive psychology and mindfulness interventions designed to improve mental or physical health.
The programmes examined varied widely in how they were delivered. Some relied on structured phone sessions, journaling paired with brief check-ins, or digital tools such as smartphone apps and text messages. Others involved interactive in-person group meetings or hybrid approaches combining face-to-face activities with online tools and virtual sessions. Most included weekly sessions alongside home-based activities to reinforce learning, with the majority lasting between six and 12 weeks.
The studies generally enrolled groups of 50 to 200 adults who already had elevated cardiovascular risk, including uncontrolled hypertension, heart failure or other related conditions. Participants were typically in their late 50s to mid-60s, and among studies that reported gender, women made up between 35 and 55 per cent of participants.
"In hypertension and postacute coronary syndrome cohorts, mindfulness-based programmes delivered over an eight-week period reduced systolic blood pressure and lowered inflammatory markers such as high-sensitivity C-reactive protein and fibrinogen," Hernandez said. "A 12-week spirituality-based digital intervention achieved one of the largest reductions -- reducing systolic blood pressure measured with a standard cuff by 7.6 points, and central systolic pressure -- which is measured in the aorta as it leaves the heart -- by 4.1 points."
According to Hernandez, previous research on positive psychology often failed to establish clearly how frequently people needed to practice these techniques, or for how long, in order to gain measurable health benefits. Her team set out to determine what level of participation was most consistently associated with improvements in cardiovascular health.
The review indicated that programmes involving more frequent contact with participants tended to produce the most reliable physiological benefits. Hernandez said this finding underscores the potential value of incorporating positive psychology strategies into long-term cardiovascular treatment and prevention plans.
The strongest behavioural changes were observed in an eight-week WhatsApp-based programme that paired weekly sessions with daily microtasks. Participants in that programme were encouraged to become more physically active, improve their diets and take medications as prescribed. Another programme incorporating motivational interviewing increased cardiac patients' activity levels by 1,800 steps per day while also improving medication adherence. By comparison, the mindfulness-focused programmes improved physical activity and diet but did not produce the same medication adherence benefit, the study found.
"The therapeutic dose that was most consistently linked with improvements in blood pressure, inflammation and endothelial function was daily practice reinforced by weekly sessions over eight to 12-week periods," Hernandez said. "Therapeutic dosing typically involved high-frequency dosing over this time period to obtain short-term physiologic benefits, while ongoing less-intensive contact may be needed to sustain behavioural change."
The study was published in the journal Cardiology Clinics. Co-authors included University of South Florida social work professor Soonhyung Kwon; Alyssa M. Vela, a professor of surgery and of psychiatry and behavioural sciences at Northwestern University Feinberg School of Medicine; and Katharine S. Edwards, a professor of cardiovascular medicine and of psychiatry and behavioural medicine at Stanford Medicine.
"The findings of this study further point to the importance of attending to mental and behavioural health for cardiovascular disease prevention and cardiovascular health optimisation," Vela said. "This speaks to the need for routine screening and integration of cardiac behavioural medicine to allow for access to important interventions."
The findings add to a growing body of evidence connecting psychological wellbeing with cardiovascular protection. Traits and experiences such as optimism, positive affect and gratitude have increasingly been associated with healthier hearts in previous research.
The new work builds on an earlier study led by Hernandez, which found that people with the highest levels of optimism tended to have healthier hearts. That research, published in the journal Health Behavior and Policy Review, was funded by the National Institutes of Health and the National Center for Research Resources. It was co-written with preventive medicine professors Kiarri N. Kershaw, Juned Siddique and Hongyan Ning of Northwestern University Feinberg School of Medicine; preventive medicine and epidemiology professor Donald M. Lloyd-Jones of Boston University Chobanian and Avedisian School of Medicine; psychology professor Julia K. Boehm of Chapman University; social and behavioural sciences professor Laura D. Kubzansky of Harvard University School of Public Health; and Distinguished Professor of Epidemiology Dr Ana Diez Roux of Drexel University.
