Evidence map›Paper›PMID 42847407›Full record

SynthesisAnnals of behavioral medicine : a publication of the Society of Behavioral Medicine2026

The physiological cost of coping: a systematic review and meta-analysis on discrimination and heart rate variability.

Giuseppe Salvo, Daniele Bomarsi, Fiorenzo Laghi, Gianluca Esposito, Julian F Thayer, Roberto Baiocco, Cristina Ottaviani

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Giuseppe SalvoDepartment of Developmental and Social Psychology, Sapienza University of Rome, Rome 00185, Italy.
Daniele BomarsiDepartment of Psychology, Sapienza University of Rome, Rome 00185, Italy.
Fiorenzo LaghiDepartment of Developmental and Social Psychology, Sapienza University of Rome, Rome 00185, Italy.
Gianluca EspositoDepartment of Psychology and Cognitive Science, University of Trento, Rovereto 38068, Italy.
Julian F ThayerDepartment of Psychology, University of California, Irvine, Irvine, CA 92697, United States.
Roberto BaioccoDepartment of Developmental and Social Psychology, Sapienza University of Rome, Rome 00185, Italy.
Cristina OttavianiDepartment of Psychology, Sapienza University of Rome, Rome 00185, Italy.ORCID 0000-0002-5240-4387

Funding

Ministry of Education and University PRIN 2022: 2022EL4MPH
6 · The paper itself

Abstract

backgroundHeart rate variability (HRV) reflects parasympathetic regulation and is typically associated with better health outcomes. However, minoritized populations, particularly African Americans, show a paradoxical pattern of higher resting HRV despite greater cardiovascular risk, a phenomenon known as the Cardiovascular Conundrum. Discrimination has been proposed as a key mechanism, but evidence remains fragmented.

methodsThe present meta-analysis quantified HRV in relation to discrimination across 3 domains: (1) resting HRV differences between minoritized and majority groups, (2) HRV reactivity to discrimination-related tasks, and (3) the association between perceived discrimination and resting HRV. A systematic search yielded 40 articles comprising 52 independent studies.

resultsMinoritized groups showed higher resting HRV than majority groups (g = .22, P < .001), as well as acute HRV reductions during discrimination-related tasks (g = -.17, P = .04), and lower resting HRV associated with greater perceived discrimination (g = -.19, P = .006). Evidence of publication bias emerged only for the latter meta-analysis. No significant moderators emerged to explain the substantial heterogeneity, with the exception of the type of HRV measure used.

conclusionsThese findings are consistent with the hypothesis that discrimination may become biologically embedded through acute vagal withdrawal during discriminatory events, a cumulative reduction in HRV associated with perceived discrimination, and a paradoxical elevation of resting HRV indicative of chronic compensatory regulation.

Indexed as

Adaptation, PsychologicalDiscrimination, PsychologicalHeart RateBlack or African AmericanCoping SkillsHumanscardiovascular conundrumhealth disparitiesmarginalizationmeta-analysisminority stressparasympathetic regulation

Identifiers

PMID42847407
PMCPMC13612168

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.