Meta-Analyses of Cardiovascular Reactivity to Rumination: A Possible Mechanism Linking Depression and Hostility to Cardiovascular Disease

Rumination is a way of cognitive coping associated with depression and hostility that prolongs cardiovascular responses to stress. If repeated over time, the associated autonomic dysregulation may be 1 mechanism linking depression and hostility to cardiovascular disease. The current meta-analyses investigate the magnitude of cardiovascular responses (heart rate, diastolic blood pressure, and systolic blood pressure) to induced state sadness and angry rumination which are associated with depression and hostility, respectively. A literature search identified 43 studies (3,348 participants) meeting inclusion criteria. A random effects model was applied to calculate cardiovascular reactivity weighted effect sizes during induced sadness and angry rumination. Large and significant effect sizes were found for all analyses, with the standardized mean statistic, d, for single group designs ranging from .75 to 1.39. Results suggest that angry rumination may have larger cardiovascular effects than sadness rumination, and that rumination likely affects blood pressure more than heart rate. Potential implications of this relationship are discussed in light of limitations of the current study and existing rumination research.