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Feeling grateful may improve health for heart failure patients

Feeling grateful may help heart failure patients heal both physically and emotionally, say U.S. researchers. 

Gratitude was linked to better sleep and mood, as well as lower levels of inflammation in people coping with heart failure in a California study.

Lead author Paul Mills said in an email that previous studies have focused on the benefits of spirituality in general, and have tied it to a better quality of life and better physical health.

Mills, who works in the departments of public health and psychiatry at the University of California, San Diego, decided to narrow this focus. He and his research team were inspired by the link between gratitude and the heart in language, such as the expression “a grateful heart,” he told Reuters Health.

“We wanted to examine gratitude in a population that has been challenged in terms of their cardiac health,” said Mills, who is also affiliated with the Chopra Center for Wellbeing in Carlsbad, California.

More than five million people in the U.S. suffer from heart failure, according to the Centers for Disease Control and Prevention. Rates are expected to nearly triple in the next few decades as the population ages, the researchers point out in Spirituality in Clinical Practice.

The study team, which included Deepak Chopra, an author and widely known proponent of alternative health, recruited 186 patients from California cardiology clinics.

All had Stage B heart failure, meaning they had some heart dysfunction and swelling but not more serious symptoms. The researchers say Stage B is an important time to intervene, as damage may still be reversed.

The participants assessed their own levels of gratitude, spiritual wellbeing and self-efficacy - the belief in their own ability to succeed at managing their heart function. The patients also rated their own depressive symptoms, sleep quality and fatigue. Lastly, researchers checked participants' blood for indicators of inflammation.

The researchers analyzed the data to determine the relationships between gratitude and spiritual wellbeing and the symptoms patients reported.

They found that patients who were more grateful reported better sleep, less depressed mood, less fatigue, higher self-efficacy and lower indicators of inflammation.

Spiritual wellbeing was tied to the same positive symptoms, but not to lower inflammation.

Mills and his colleagues also found that the link between improved health and spiritual wellbeing was at least partially explained by the role gratitude plays in spirituality. “It was the gratitude aspect of spirituality that accounted for those effects, not spirituality per se,” Mills noted.

Nina Kupper, a professor of medical psychology at Tillburg University in the Netherlands, thinks the researchers may be overemphasizing the role of gratitude, saying that it is not responsible for all the effects of spirituality.

However, Kupper noted in an email, positive emotions are generally associated with better health and that, “Gratitude as a concept might be tapping into these positive emotions more than spirituality does.”

Mills also described a sub-study, in which some patients were assigned to add eight weeks of gratitude journaling to their usual treatment. “We used gratitude journaling as a way to consciously cultivate gratitude, with the aim of increasing its presence in the patients’ lives,” he explained.

The sub-study found that patients who did the journal exercise had reduced indicators of inflammation and increased heart-rate variability, another measure of reduced risk, compared to their readings at the beginning of the study. A comparison group that didn’t do the journaling exercise had no changes in these measures.

Kupper, who was not involved in the study, stressed the importance of positive emotions to the recovery process, saying that these feelings are “very important in keeping the balance between illness burden and a person’s capacity to deal with the illness.”

She noted that this is especially true for heart failure patients, who often experience other illnesses as well, such as kidney disease, anemia and diabetes.

According to Mills, “It seems that a more grateful heart is indeed a more healthy heart.” He advised that “gratitude journaling is an easy way to support cardiac health.”