Rumination intensifies and prolongs cardiovascular responses to stress. This emotion regulation strategy is characteristic of depression and hostility and may be a mechanism linking these dispositions to cardiovascular disease (CVD). The current meta-analyses investigate the magnitude of cardiovascular responses to rumination and the effectiveness of distraction in curtailing these responses. A literature search identified studies with rumination conditions and corresponding cardiovascular measures. A random effects model was applied to calculate heart rate (HR), diastolic blood pressure (DBP), and systolic blood pressure (SBP) weighted effect sizes for reactivity and recovery to angry rumination, sadness rumination, and rumination on positive emotion; heart rate variability (HRV) responses to angry rumination; as well as differences in cardiovascular reactivity to rumination vs. distraction conditions. Large and significant reactivity effect sizes were found for all cardiovascular variables to all rumination subtypes. For angry rumination, DBP and SBP reactivity were significantly greater than HR reactivity. Recovery to sadness and angry rumination yielded significant effect sizes for SBP. There was a significant DBP effect size difference between angry rumination and distraction conditions. Sex and race/ethnicity did not moderate any calculated effect sizes; while a few study factors did. Results suggest that rumination may contribute to CVD vulnerability and that distraction is not particularly effective at decreasing the magnitude of cardiovascular responses to induced rumination. Additionally, blood pressure may be of greater concern than HR when considering the cardiovascular implications of rumination, with angry rumination exerting the largest increases in blood pressure.
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Meta-analyses of cardiovascular responses to rumination : exploring mechanisms linking depression and hostility to cardiovascular disease.