Relationship between cognitive emotion regulation strategies and coronary heart disease: an empirical examination of heart rate variability and coronary stenosis

Objective: Despite longstanding interest in emotion regulation and cardiovascular health, limited studies have investigated the relationship between cognitive emotion regulation (CER) strategies and coronary heart disease (CHD) using objective measures of heart rate variability (HRV) and coronary stenosis. This study aimed to objectively explore the associations between CER strategies and both HRV and coronary stenosis and provide empirical evidence for the relationship between emotion regulation and CHD. Methods: Questionnaires on CER strategies were distributed to 251 CHD patients and 250 healthy persons. HRV and coronary stenosis were measured for CHD respondents using the 24-h dynamic electrocardiogram and coronary angiography, respectively. Results: CHD patients with low HRV/severe stenosis used maladaptive emotion regulation more frequently and adaptive emotion regulation less frequently. Various maladaptive emotion regulation strategies (e.g. acceptance, rumination, putting into perspective) were positively associated with lower HRV and coronary stenosis severity, while adaptive emotion regulation strategies (e.g. positive refocusing, refocusing on planning) were negatively associated with lower HRV and coronary stenosis severity. Conclusions: Patients with more serious diseases exhibited increased maladaptive emotion regulation, which was associated with lower HRV and severe coronary stenosis. Further, adaptive emotion regulation was associated with higher HRV and moderate coronary stenosis.