Margery Quackenbush, 72, was always told by her doctor that she was healthy. And despite the New York woman's family history of heart disease -- she had a brother and a grandfather who had both had heart attacks -- and the stress of her job, she didn't worry about any medical problems. It was not until October 2007, during a stressful day at work, that she began to feel chest pains and was rushed to the hospital.
Quackenbush had a blocked artery. Doctors were fortunately able to place a stent in her heart to prop open the artery and solve the problem.
Physically, that may have been the end of Quackenbush's heart troubles. But psychologically, the aftermath of the episode was just beginning.
"Initially I felt that my life was over, I always heard that my heart was fine but this was a total shock," she said. "I felt very anxious that this would happen again."
A new review published Tuesday in the Psychological Bulletin shows that patients with a positive psychological well being have a reduced risk of cardiovascular disease compared with those who have a more negative or neutral attitude towards life. The effect appeared to be somewhat tied to satisfaction with life in general and contentment at the workplace. But optimism, more than any other factor studied, appeared to be most strongly linked to heart health.
The review may seem to confirm what many have long suspected about a positive outlook and heart health. But it is actually the first review of its kind to take a comprehensive look at all of the evidence on the connection between psychological well being and a healthier heart.
Julia Boehm, research fellow at the Harvard School of Public Health and lead author of the study, said in a news release that past research shows that individuals who are optimistic enjoy "an approximately 50 percent reduced risk of experiencing an initial cardiovascular event compared to their less optimistic peers."
Other physicians agree that when it comes to the heart, a bit of positive outlook can't hurt.
"I believe there is ample evidence showing that positive psychological well being is associated with reduced cardiovascular disease risk, independently of the impact of negative psychological factors -- e.g., depression, anxiety, hostility, etc. -- that increase risk," Dr. Redford Williams, chief of the division of behavioral sciences at Duke University in Durham, N.C., wrote in an email to ABC News.
So why do optimistic people have a special protection mechanism against heart disease? Williams said the answer may simply be that these people generally tend to lead healthier lives and are able to handle stress much better -- skills that ultimately help prevent further cardiovascular events.
"I believe that positive psychological well being (optimism) contributes to reduced cardiovascular risk via effects to improve lifestyle behaviors and to reduce physiological activation during stress," Williams said.
The results of the new review show this might hold true even for patients who have had a previous cardiac event, such as a heart attack or bypass surgery. One study the authors examined as part of their review showed patients who have bypass surgery still benefit from being optimistic; their recoveries are faster, and they have a reduced risk of readmission to the hospital for issues related to their heart surgery.
But a patient's disposition is a double-edged sword, research suggests. Dr. Robert Allan, a clinical assistant professor of psychology in medicine at Weill Cornell Medical College who specializes in patients with psychological conditions after cardiac events, said that for pessimistic patients, the opposite can hold true.
"The big three psychosocial risk factors are depression, social isolation, and anger which are linked with cardiovascular disease," Allan said. "It's likely that putting a positive spin on the psyche will cause a benefit for patients." Indeed, many previous studies have demonstrated an increased risk in cardiovascular events with negative attitudes such as depression or anger.
As for Quackenbush, her cardiologist referred her Allan, who arranged for her to join a social support group. She said that being a part of this group helped her change her negative feelings, including anxiety, into positive approaches in handling stress that have helped with her course of disease.
Today, Quackenbush said, she is thankful for her past brush with heart trouble.
"It was a wakeup call," she said. "It was a wakeup call that made me change my lifestyle."