The Role of Angry Rumination and Distraction in Blood Pressure Recovery From Emotional Arousal

Objective: Cardiovascular recovery of prestress baseline blood pressure has been implicated as a possible additional determinant of sustained blood pressure elevation. We hypothesize that angry ruminations may slow the recovery process. Method: A within-subjects design was used in which resting baseline blood pressure and heart rate measurements were assessed on 60 subjects, who then took part in two anger-recall tasks. After each task, subjects sat quietly and alone during a 12-minute recovery period randomized to with or without distractions. During baseline, task, and recovery, blood pressure was continuously monitored; during recovery, subjects reported their thoughts at five fixed intervals. Results: Fewer angry thoughts were reported in the distraction condition (17%) compared with no distraction (31%; p = .002); an interaction showed that this effect was largely the result of the two intervals immediately after the anger-recall task. Trait rumination interacted with distraction condition such that high ruminators in the no-distraction condition evidenced the poorest blood pressure recovery, assessed as area under the curve (p = .044 [systolic blood pressure] and p = .046 [diastolic pressure]). Conclusions: People who have a tendency to ruminate about past anger-provoking events may be at greater risk for target organ damage as a result of sustained blood pressure elevations; the effect is exacerbated when distractions are not available to interrupt the ruminative process. ANOVA = analysis of variance; AUC = area under the curve; BP = blood pressure; HTN = hypertension; CHD = coronary heart disease; CVR = cardiovascular reactivity; CVD = cardiovascular disease; HR = heart rate; DAB-VR = Destructive Anger Behavior-Verbal Rumination; DBP = diastolic BP; HPA = hypothalamic-pituitary-adrenal; SBP = systolic BP.