Influence of psychological well-being on health: Systematic review and meta-analysis of hypertension, overweight/obesity, and mortality, including suicide.

OBJECTIVES

Psychological well-being (PWB) has demonstrated health-protective effects, but its impact on specific causes of death and cardiovascular risk factors incidence has received limited attention. This systematic review and meta-analysis (PROSPERO Registration: CRD42023387665) examine any positive dimension of PWB's association with the incidence of hypertension, overweight/obesity, metabolic syndrome, deaths from suicide, and noncommunicable disease mortality in the general adult population.

METHOD: PubMed and PsycINFO were searched up to June 3, 2023. Random-effects meta-analyses estimated different outcome effect sizes. Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were followed. Heterogeneity was assessed using the I² statistic, studies quality with the Newcastle-Ottawa scale, publication bias through funnel plots, and Egger's test. Subgroup (PWB dimensions, sex, quality assessment, sample size, follow-up period, and publication dates) and metaregression analyses were conducted.

RESULTS

The search identified 6,200 studies, with 159 articles eligible for review and 130 for meta-analysis. Higher PWB was associated with lower all-cause mortality (OR = 0.798, 95% confidence interval [CI] [0.773, 0.823], I² = 88.03%), and mortality from causes like suicide (OR = 0.505, 95% CI [0.337, 0.756], I² = 0.0%), cancer (OR = 0.924, 95% CI [0.858, 0.995], I² = 35.42%), cardiovascular disease (OR = 0.769, 95% CI [0.712, 0.832], I² = 55.64%), stroke (OR = 0.726, 95% CI [0.615, 0.858], I² = 56.96%), coronary heart disease (OR = 0.823, 95% CI [0.735, 0.922], I² = 45.03%), and hypertension incidence (OR = 0.921, 95% CI [0.860, 0.987], I² = 68.91%). No significant association was found for overweight/obesity incidence (OR = 0.922, 95% CI [0.801, 1.061], I² = 0.0%). Common sources of heterogeneity could not be identified.

CONCLUSION

Higher PWB was associated with lower noncommunicable disease mortality, likely including suicide, and lower hypertension incidence. The limited number of studies on some outcomes, along with potential publication bias and heterogeneity, constrain definitive conclusions. (PsycInfo Database Record (c) 2025 APA, all rights reserved).