New research suggests that recognizing and giving thanks for the positive aspects of life can result in improved mental, and ultimately physical, health in patients with asymptomatic heart failure.

Gratitude is part of a wider outlook on life that involves noticing and appreciating the positive aspects of life. It can be attributed to an external source (e.g., a pet), another person or a non-human (e.g., God).

"We found that more gratitude in these patients was associated with better mood, better sleep, less fatigue and lower levels of inflammatory biomarkers related to cardiac health," Paul J. Mills, lead author of the study, said in a statement

Gratitude is also commonly an aspect of spirituality, said Mills. Because previous research has shown that people who considered themselves more spiritual had greater overall well-being, including physical health, Mills and his colleagues examined the role of both spirituality and gratitude on potential health markers in patients.

For the study, researchers collected and analyzed data from 186 men and women had been diagnosed with asymptomatic (Stage B) heart failure for at least three months. Stage B consists of patients who have developed structural heart disease (e.g., have had a heart attack that damaged the heart) but do not show symptoms of heart failure (e.g., shortness of breath or fatigue). This stage is an important therapeutic window for halting disease progression and improving quality of life since Stage B patients are at high risk of progressing to symptomatic (Stage C) heart failure, where risk of death is five times higher, according to Mills.

They found higher gratitude scores were associated with better mood, higher quality sleep, more self-efficacy and less inflammation. Inflammation can often worsen heart failure.

What surprised the researchers about the findings, though, was that gratitude fully or partially accounted for the beneficial effects of spiritual well-being.

"We found that spiritual well-being was associated with better mood and sleep, but it was the gratitude aspect of spirituality that accounted for those effects, not spirituality per se," Mills said.

The findings are detailed in the journal Spirituality in Clinical Practice.