Religiosity, spirituality, and cardiovascular reactivity to acute psychological stress: A systematic review

Cardiovascular reactivity to acute psychological stress may be an underlying mechanism that links religiosity and spirituality to better cardiovascular health. However, studies examining religiosity, spirituality and cardiovascular reactivity to acute stress have inconsistent findings; further whether it is religiosity or spirituality or both that is driving reported effects is not clear. To address this gap, we conducted a systematic review of the literature examining religiosity and/or spirituality and cardiovascular reactions to acute stress. Electronic databases were systematically searched (PubMed, PsycArticles, PsycInfo, CINAHL and Web of Science). After removal of duplicates, screening titles and abstracts, twelve peer-reviewed studies were included in the review. Overall, the majority of studies reported on an inverse relationship between religiosity and/or spirituality and cardiovascular reactivity, showing higher levels of religiosity and spirituality were associated with attenuated cardiovascular responses. This was particularly evident when measures assessed facets of intrinsic religiosity and focused on internalized spiritual beliefs, focusing on spiritual aspects such as finding meaning and purpose in life. However, in three studies, religiosity and/or spirituality showed exaggerated cardiovascular responses, importantly these studies examined religious/spiritual struggles, indicating that religiosity/spiritual struggles can have a negative impact on health. To date, no study has controlled for religiosity when examining spirituality and cardiovascular reactivity, or vice versa, to explore whether the outcomes differ. Overall, this review highlights that religiosity, and spirituality have potential health benefits for cardiovascular reactivity, however religious/spirituality struggles can diminish these positive effects. It is a priority for future research to clearly define, differentiate and measure the constructs of religiosity and spirituality separately, as both have demonstrated beneficial effects on cardiovascular reactivity.