Associations between subjective and objective well-being and risk of cardiometabolic disease: A prospective cohort study from the UK biobank

Background: The distinct and combined impacts of subjective well-being (SWB) and objective well-being (OWB) on cardiometabolic diseases and cardiometabolic multimorbidity remain largely unknown. Methods: 141,086 participants (mean age 56 years) were included from the UK Biobank study from 2006 to 2010. The SWB included happiness and life satisfaction. The OWB represents the level of satisfaction with objective conditions which was created using latent class analysis. Cardiometabolic diseases comprise diabetes and cardiovascular disease, including coronary heath disease and stroke. The Cox models were used to estimate the hazard ratio (HR) and 95 % confidence intervals (95 % CI) of the individual and combined associations between SWB and OWB with the risk of cardiometabolic diseases. Results: During a median follow-up of 12 years (1,693,800 person-years), 16,678 new-onset cardiometabolic diseases were reported. In full-adjusted model, the HR (95 % CI) among men with high SWB was 0.93 (0.82-1.05), 0.85 (0.79-0.92) and 0.71 (0.57-0.87), for diabetes, cardiovascular disease, and cardiometabolic multimorbidity, compared to low SWB, respectively. Among women with high SWB, the HR (95 % CI) was 0.71 (0.62-0.81), 0.76 (0.69-0.83) and 0.55 (0.42-0.72) for diabetes, cardiovascular disease and cardiometabolic multimorbidity, respectively. Low OWB increases the cardiometabolic diseases risk by from 16 % to 103 %. Notably, high SWB was associated with lower cardiometabolic diseases risk among individuals with low OWB. Limitations: Potential recall bias and residual confounding are the main limitations. Conclusions: We found that both high SWB and OWB were significantly associated with a lower risk of cardiometabolic diseases, more evident among women. The association between SWB and cardiometabolic diseases was independent of OWB.