Anger inhibition, cardiovascular recovery, and vagal function: A model of the line between hostility and cardiovascular disease

A model of the association between hostility and cardiovascular disease (CV D) is proposed based upon anger inhibition, slow cardiovascular recovery, a nd low parasympathetic activity (vagal tone). This model is opposed to the more conventional model that emphasizes anger expression, cardiovascular re activity, and high sympathetic tone. We argue that in social reality, incid ences of anger inhibition outnumber incidences of anger expression to a gre at extent, irrespective of preferred expression style. Moreover slow cardio vascular recovery, rather than high reactivity, may be the mechanism underl ying the CVD risk associated with anger inhibition. Both anger inhibition a nd slow cardiovascular recovery are associated with a persistently low vaga l tone. Thus, the anger inhibition/vagal inhibition model seems more consis tent with the actual nature of anger in daily life and with the known cardi ovascular control mechanisms. The model may better account for the chronic pathophysiological state that is believed to lend to CVD. importantly an ex perimental inhibition/recovery paradigm might also allow to test potential behavioral and cognitive accelerators of cardiovascular recovery. As an exa mple of an important socially-mediated health risk that may be elucidated u sing the anger inhibition/vagal inhibition model, we discuss Black-White di fferences that have been found in CVD.