© 2018 Elsevier Ltd Motor vehicle collisions are the leading cause of death in people ages 5–34 in the US, and secondary task engagement, such as talking on a cell phone, is a leading contributor to motor vehicle collisions. The negative effects of secondary task engagement on driving performance has become a prominent recent topic of study given the increasing amount of time drivers engage in distracted driving. However, few studies have examined the effects of secondary task engagement while driving on health related outcomes such as cardiovascular reactivity. Cardiovascular reactivity, as measured by heart rate and blood pressure, has been used in previous studies as a means of measuring effort in task engagement as well as a means to predict cardiovascular disease and stroke. This study investigates the effect of secondary task (talking on a cell phone, texting, and driving with no task) while driving in a simulator on cardiovascular reactivity. Using difference scores between baseline (a period of inactivity) and stimulus (driving with no task and driving with secondary tasks), a repeated measures analysis of variance using a mixed model approach was used to determine the effect of secondary task on cardiovascular reactivity. Findings indicated that talking on a cell phone while driving significantly increased cardiovascular reactivity via heart rate and blood pressure compared to driving with no task. Texting while driving did not differ significantly from driving with no task. This study demonstrates the need for more research on the long term effects of secondary tasks while driving on cardiovascular reactivity and for assessing the risks associated with secondary task use while driving on developing cardiovascular disease or stroke.