text: If you want to stay healthy, try saying 'thank you' more often. Feeling grateful can improve the health of our hearts, according to a new study. Researchers found that heart patients who expressed gratitude for the positive things in their life had improved mental, and ultimately physical, health. The study involved men and women who had been diagnosed with Stage B heart failure. Heart patients who expressed gratitude for the positive things in their life had better mental and physical health, a study found . Stage B is where patients have developed structural heart disease - they may, for example, have had a heart attack that damaged the heart - but do not show symptoms of heart failure, such as shortness of breath or fatigue. It is important to make beneficial lifestyle changes at this stage because patients are at a high risk of progressing to Stage C heart failure - where risk of death is five times higher - the researchers said. The 186 patients were assessed for their levels of gratitude using standard psychological tests. These scores were then compared with the patients’ scores for depressive symptoms, sleep quality, fatigue, self-efficacy (belief in our ability to deal with a situation) and inflammatory markers. Inflammation can often worsen heart failure. ‘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,’ said Professor Paul Mills, from the University of California. Patients who were more grateful had lower markers of inflammation, which can worsen heart failure . To further test their findings, the researchers asked some of the patients to write down three things for which they were thankful most days of the week for eight weeks. Both groups continued to receive their normal clinical care during that time. ‘We found that those patients who kept gratitude journals for those eight weeks showed reductions in circulating levels of several important inflammatory biomarkers, as well as an increase in heart rate variability while they wrote,’ said Professor Mills. ‘Improved heart rate variability is considered a measure of reduced cardiac risk. ‘It seems that a more grateful heart is indeed a more healthy heart, and that gratitude journaling is an easy way to support cardiac health.’ The research was published in the journal Spirituality in Clinical Practice.
target: Heart patients who were more grateful had improved physical health .
  They had lower markers for inflammation - which can worsen heart failure .
  They also had better moods, better sleep, and less fatigue, experts found .
  Writing a 'gratitude journal' is also linked with better heart health, they said .