Rosalba (Rose) Hernandez, a professor of social work at the University of Illinois Urbana-Champaign, led the research team. The group reviewed results from 18 randomized controlled trials that tested positive psychology and mindfulness interventions designed to improve mental or physical health.

How the Heart Health Programs Worked

The programs varied widely in how they were delivered. Some relied on structured phone sessions, journaling paired with brief check-ins, or digital tools such as apps and text messages. Others involved interactive in-person group meetings or hybrid approaches that combined face-to-face activities with online tools and virtual sessions.

Most programs included weekly sessions along with activities participants completed at home to reinforce what they had learned. The majority lasted between six and 12 weeks.

The studies generally enrolled groups of 50-200 adults who already had elevated cardiovascular risk, including uncontrolled hypertension, heart failure, or other health conditions. Participants were usually in their late 50s to mid-60s. Among studies that reported gender, women made up 35-55% of the participants.

"In hypertension and postacute coronary syndrome cohorts, mindfulness-based programs delivered over an eight-week period reduced systolic blood pressure and lowered inflammatory markers such as high-sensitivity C-reactive protein and fibrinogen," said Hernandez, who is a Fellow of the American Heart Association. "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."

Finding the Right "Dose" of Positivity

Previous research on positive psychology often did not clearly establish how frequently people needed to practice these techniques, or for how long, to gain health benefits, Hernandez said. Her team wanted to determine what level of participation was most consistently associated with improvements in cardiovascular health.

The review showed that programs with more frequent participant contact tended to produce the most reliable physiological benefits. Hernandez said this finding highlights the potential value of incorporating positive psychology strategies into long-term cardiovascular treatment and prevention.

The strongest behavioral changes came from an eight-week WhatsApp-based program that paired weekly sessions with daily microtasks. Participants were encouraged to become more physically active, improve their diets, and take their medications as prescribed.

Another program that incorporated motivational interviewing increased cardiac patients' activity by 1,800 steps per day while also improving medication adherence. By comparison, the mindfulness programs improved physical activity and diet, but did not produce the same medication adherence benefit, according to the study.

"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 behavioral change."

Mental Health as Part of Heart Care

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 behavioral sciences at Northwestern University Feinberg School of Medicine; and Katharine S. Edwards, a professor of cardiovascular medicine and of psychiatry and behavioral medicine at Stanford Medicine.

"The findings of this study further point to the importance of attending to mental and behavioral health for cardiovascular disease prevention and cardiovascular health optimization," Vela said. "This speaks to the need for routine screening and integration of cardiac behavioral medicine to allow for access to important interventions."

The findings contribute to a growing body of evidence connecting psychological well-being with cardiovascular protection. Traits and experiences such as optimism, positive affect, and gratitude have increasingly been associated with healthier hearts.

Earlier Research Linked Optimism to Healthier Hearts

The new work builds on a prior study led by Hernandez, which found that people with the highest levels of optimism tended to have healthier hearts. That research was published in the journal Health Behavior and Policy Review.

That earlier study 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, all 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 behavioral sciences professor Laura D. Kubzansky of Harvard University School of Public Health; and Distinguished Professor of Epidemiology Dr. Ana Diez Roux of Drexel University.