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

Background

Heart 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.