Association of positive well-being with reduced cardiac repolarization abnormalities in the First National Health and Nutrition Examination Survey

Background: The mechanisms by which psychological factors may influence possibly arrhythmia risk are not known. We hypothesized that psychological wellness, measured by the General Well-Being Schedule (GBWS), is associated with less repolarization heterogeneity as measured by T-axis. We also explored whether T-axis was a mediator in the relationship of GWBS with adverse cardiac outcomes. Methods: We studied 5533 adults aged 25–74 years without a history of CVD from NHANES I (National Health and Nutrition Examination Survey) (1971–75). Frontal T-axis was obtained through 12-lead ECG and characterized as normal (15° to 75°), borderline (−15° to 15° or 75° to 105°) or abnormal (>105° or <−15°). Results: The mean ± SD age was 43.1 ± 11.5 years and 55% were women. A 1-SD increase in GWBS score associated with a 23% reduced odds of abnormal T-axis (p < 0.001) and 11% lower hazard of composite CHD hospitalization and death (p = 0.02). When adjusting for sociodemographic factors, health behaviors, and CHD risk factors, the association was minimally changed and remained statistically significant. Additional adjustment for T-axis did not change the relationship with outcomes. Conclusion: General well-being is independently associated with less abnormal frontal T-axis and CHD events in otherwise healthy individuals.