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

From the Columbia University/NY-Presbyterian Hospital (W.G., K.W.D., T.G.), New York, NY; the University of California (N.J.S.C.), San Diego, La Jolla, CA; and State University of New York (J.E.S.), Stony Brook, Stony Brook, NY.

Address correspondence and reprint requests to William Gerin, PhD, Columbia University Medical Center, 622 West 168th Street, New York, NY 10032. E-mail: wg131{at}columbia.edu

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.

Key Words: cardiovascular reactivity • blood pressure • anger • hypertension • rumination

Abbreviations: 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.

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