Heartfelt Appreciation: How Thanks Can Heal Your Heart


• A new study finds workplace appreciation linked to lower cardiovascular disease risk.
• Stress from lack of appreciation may increase heart disease risk.
• Recognition and gratitude promote employee well-being and heart health.

Part of a series on stress.


What if just a few words of appreciation could slow down the leading cause of death in the United States? According to a study conducted by researchers at the University of Konstanz and published in Public Health, higher appreciation at work is significantly and independently associated with lower cardiovascular heart disease. One hundred and three male participants reported their feelings of appreciation at work, social support, and self-esteem, and their risk of heart disease was assessed using various blood tests. A higher appreciation at work was related to a lower overall risk for cardiovascular heart disease, particularly lower blood pressure and lower cholesterol. Encouraging appreciation at work may help reduce the development and progression of cardiovascular heart disease.

Heart Disease and Stress in the U.S.

Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States. Coronary heart disease is the most common type of heart disease, affecting about 1 in 20 adults aged 20 and older. Every year, about 805,000 people in the United States have a heart attack. Heart disease costs the United States about $239.9 billion each year, including costs of healthcare services, medicines, and lost productivity due to death. Current treatments include lifestyle changes: healthier diets, greater physical exercise, and managing stress. Medication is often included in a treatment plan to widen blood vessels and manage cholesterol levels.

Work-related stress is pervasive in the United States, with 83% of American workers suffering from work-related stress and over 25% saying work is the number one stressor in their lives. About one million Americans miss work each day because of stress, costing businesses $51 billion a year, as well as an additional $26 billion in treatment costs. The main causes of workplace stress are workload (39%), interpersonal issues (31%), juggling work and personal life (19%), and job security (9%). Making employees feel appreciated and valued in the workplace would provide significant relief to the many Americans suffering from both heart disease and work-related stress.

Benefits of Appreciation

Feeling valued and appreciated by other people has a number of positive effects. It is associated with the fundamental human motive to get along or belong to a social group. It also serves as a reward factor at work, counterbalancing the amount of work stress. Appreciation boosts self-esteem and buffers stress experiences, communicating care, esteem, empathy, and understanding.

Evidence for the influence of appreciation on health and well-being tends to overlap with numerous constructs and measures. Higher appreciation at work is associated with higher well-being, serenity, enthusiasm and contentment, job satisfaction, lower feelings of resentment, as well as better psychological functioning. It is also associated with higher levels of subjective health, lower levels of depressive symptoms, anxiety, emotional exhaustion, lower back pain, lower risk of sickness absence, and fewer early retirements. It is clear that feelings of appreciation have many benefits. Still, the distinct impact of appreciation on heart health was unclear until the recent study conducted at the University of Konstanz.

Measuring the Impact of Appreciation on Heart Health

The study measuring the impact of appreciation on heart health included 103 male participants, 25 participants diagnosed with coronary heart disease, 40 hypertensive participants (32 were medication-free, and eight were medicated at study participation), 32 normotensive participants, and six with masked hypertension. Participants measured their blood pressure on six separate occasions at home, and trained personnel obtained three additional measurements.

Psychological measurements and blood samples were collected at the research lab. Appreciation at work was measured with a 10-item Bern appreciation scale that asked participants to rate the extent to which they felt appreciated by supervisors and co-workers. Social support was assessed by the eight item subscale of the Berlin social support scale. Participants rate their agreement with statements such as “There are people that offer me help when I need it.” The 10-item Rosenberg self-esteem scale measured global self-esteem, with participants rating positive and negative feelings about themselves. Lastly, the amount of strain induced by lack of appreciation at work was measured using the effort-reward imbalance at work questionnaire.

The risk of coronary heart disease was assessed by measuring blood pressure, the diabetes marker HbA1c, blood lipids TC and HDL-C, coagulation activity in terms of the prothrombotic factors D-dimer and fibrinogen, and pro-inflammatory measures IL-6, TNF-α, and CRP.

Study Results

Statistical multivariate analysis of covariance reveals that appreciation at work is significantly related to the risk of coronary heart disease, both with and without controlling for medication intake, age, BMI, and smoking. Higher appreciation at work is associated with lower blood pressure and lower cholesterol but not with the diabetes marker HbA1c or the coagulation and inflammatory indices. The study authors conclude that taken together, “appreciation may not only buffer stress effects with the associated increase in cardiovascular risk but also actively contribute to better cardiovascular health.”

Practical Examples of Appreciation at Work

Professor and author Gary Yukl provides practical examples of how to provide authentic appreciation at work: 1. recognizing a variety of contributions and achievements, 2. actively searching for contributions to recognize, 3. recognizing improvements in performance, 4. recognizing commendable efforts, even if they failed, 5. not limiting recognition to high-visibility jobs, 6. not limiting recognition to a few best performers, 7. providing specific recognition, 8. providing timely recognition, and 9. using an appropriate form of recognition.

As we confront the staggering statistics of heart disease and workplace stress in the U.S., the notion of appreciation emerges not only as a remedy but as a proactive measure for safeguarding both employee well-being and organizational success.

© William A. Haseltine, PhD. All Rights Reserved.