Effect of anger and trait forgiveness on cardiovascular risk in young adult females

Am J Cardiol. 2014 Jul 1;114(1):47-52. doi: 10.1016/j.amjcard.2014.04.007. Epub 2014 Apr 18.


High trait anger is linked to adverse cardiovascular outcomes. A potential antidote to the cardiotoxic influence of anger is trait forgiveness (TF), as it has shown associations with improved blood pressure (BP) and cardiovagal tone regulation in cardiac patients. However, it has yet to be determined if anger and forgiveness independently predict cardiovascular parameters. Trait anger (State-Trait Anger Expression Inventory-2) and TF (Tendency to Forgive Scale) were evaluated in 308 (M = 21.11years ± SD = 2.52) healthy female volunteers allocated to 3 related, yet distinct, studies. Hierarchical multiple regressions tested the incremental contribution of TF after accounting for anger. Study 1 assessed autonomic modulation through beat-to-beat BP and spectral analysis to examine sympathovagal balance and baroreflex functioning. Study 2 used tonometry and pulse wave analysis for aortic hemodynamics. Study 3 assessed 24-hour ambulatory BP and ambulatory arterial stiffness index. Hierarchical models demonstrated that anger was significantly associated with increased sympathovagal tone, increased hemodynamic indices, high ambulatory BPs, and attenuated BP variability and baroreflex. In contrast, TF was associated with more favorable hemodynamic effects (i.e., decreased ventricular work and myocardial oxygen consumption). In conclusion, these results demonstrate divergent cardiovascular effects of anger and forgiveness, such that anger is associated with a more cardiotoxic autonomic and hemodynamic profile, whereas TF is associated with a more cardioprotective profile. These findings suggest that interventions aimed at decreasing anger while increasing forgiveness may be clinically relevant.

MeSH terms

  • Adaptation, Psychological / physiology
  • Anger / physiology*
  • Anthropometry
  • Autonomic Nervous System / physiopathology
  • Baroreflex / physiology
  • Beneficence*
  • Blood Pressure Monitoring, Ambulatory
  • Cardiovascular Diseases / physiopathology*
  • Electrocardiography
  • Female
  • Heart Rate / physiology
  • Hemodynamics / physiology
  • Humans
  • Hypertension / physiopathology
  • Surveys and Questionnaires
  • Temperament / physiology*
  • Young Adult