Spirituality Boosts Heart Health, Studies Show

A growing body of research links purpose, gratitude, and hope to better cardiovascular outcomes.

Can spirituality impact heart health? Emerging evidence suggests that qualities like a sense of purpose, gratitude, and hope—even when divorced from traditional religious practices—can lead to significant improvements in cardiovascular health and adherence to treatment plans.

Differentiating Spirituality from Religiosity

At the 45th Congress of the Cardiology Society of the State of São Paulo, experts explored the connection between a patient’s subjective experience and tangible clinical benefits, such as fewer hospitalizations and better blood pressure control. Fernando Nobre, a cardiologist and hypertension specialist, opened the discussion by emphasizing the distinction between spirituality and religiosity.

According to Nobre, religiosity involves structured beliefs and rituals within a faith community. In contrast, “spirituality goes further. It cuts across and transcends a person’s life, shaping their choices and way of living.” Scientific frameworks can assess these values.

Individuals who consider themselves spiritual often exhibit lower blood pressure and a decreased risk of developing hypertension. Studies suggest that these benefits stem from reduced peripheral vascular resistance, improved cardiac output, and greater adherence to medical advice, particularly among women.

The Brazilian Feel Study

Nobre cited the Brazilian Feel study, helmed by cardiologist Maria Emília Figueiredo Teixeira at the Brazilian Federal University of Goiás. Published in 2024, the study monitored 100 individuals with hypertension for 12 weeks. One group received short, non-religious videos promoting spiritual reflection via WhatsApp and were encouraged to contemplate gratitude, forgiveness, life purpose, and optimism.

The WhatsApp group experienced a notable decrease in blood pressure and enhanced endothelial function, as measured by flow-mediated dilation. According to the CDC, about half of adults in the United States have hypertension (CDC.gov).

“If spirituality appears to influence both key components of blood pressure, that alone is reason enough for us to understand it better,” Nobre stated.

Impact on Heart Failure

Spirituality seems to bolster psychological resilience and influence the pathophysiology of heart failure. Research indicates that spiritually engaged individuals exhibit reduced sympathetic nervous system activity, lower stress hormone levels, and decreased inflammatory cytokines. These changes correlate with fewer symptoms, reduced hospitalizations, and improved quality of life.

Rafael Nunes, a cardio-oncologist, highlighted a 2022 review featured in JACC: Heart Failure. The review analyzed 47 studies, revealing a consistent link between heightened spirituality and lower rates of anxiety and depression, improved treatment adherence, fewer hospital admissions, and, in certain instances, reduced mortality.

A 2023 follow-up emphasized that merely participating in religious organizations was insufficient to guarantee clinical benefits. “It’s the spiritual experience — the meaning a person assigns to their life, beliefs, and motivations — that is associated with positive outcomes,” Nunes clarified.

One study, Is Belonging to a Religious Organization Enough?, found that spirituality correlated with lower levels of anger, anxiety, and emotional exhaustion, while religiosity alone did not significantly impact emotional well-being.

Stress and Coronary Artery Disease

While coronary artery disease can remain stable for years, its progression to acute myocardial infarction can be abrupt. Plaque ruptures are often caused by acute neuro-immuno-hormonal and inflammatory responses.

Roberto Veiga Giraldez, director of the Acute Coronary Care Unit at the Heart Institute, Hospital das Clínicas, University of São Paulo, referenced studies connecting acute myocardial infarction to external stressors like natural disasters and sporting events. He noted that during such events, sympathetic nervous system activation and systemic inflammation intensify, elevating the risk of acute coronary syndromes.

A South Korean study revealed a spike in acute coronary syndrome cases in cities vulnerable to earthquakes following seismic events. Similarly, an analysis of the 2006 FIFA World Cup in Germany found that rates of myocardial infarction increased during high-stakes national team matches, particularly during tense moments.

“These data illustrate how acute stress can influence outcomes in patients with coronary artery disease,” said Giraldez. “Spirituality can help mitigate this impact. Resignation and faith — whatever form they take — can help individuals face stressful situations with greater composure.”

Integrating Spirituality into Clinical Care

Nunes suggests that spirituality should be incorporated into clinical practice with sensitivity to individual values and preferences. “We should approach spirituality with the same seriousness we apply to mental health and lifestyle habits. Understanding what matters to the patient and why they seek care can shape the therapeutic journey,” he stated.

He recommends integrating spiritual assessment into palliative care and multidisciplinary strategies, especially in advanced heart failure. “Nutritionists, nurses, psychologists — everyone can play a role in listening,” he added.

Nobre stressed that addressing spirituality can be simple: “During the medical history, when we ask about lifestyle, why not also ask how the illness is affecting them emotionally? Or whether they believe in something greater?”

“We’re not necessarily talking about religion,” he continued. “The point is: Does it matter to them? When we make that connection, care moves beyond the physical body. It becomes whole-person care — addressing mind, emotions, and values. And that’s when medicine reaches its fullest potential,” Nobre concluded.