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09-01-2012 | Cardiology | Article

Grief after death of a loved one linked to increased heart attack risk


Free abstract

MedWire News: Individuals who have recently experienced the loss of a loved one may be at an increased risk for acute myocardial infarction (AMI), researchers say.

The acutely increased risk observed may be due to neglect of regular medications, psychological stress, reduced amount of sleep, low appetite, and elevated cortisol level at the start of the grieving process, suggest Elizabeth Mostofsky (Harvard Medical School, Boston, Massachusetts, USA) and co-authors in the journal Circulation.

They conducted a case-crossover analysis of 1985 participants from the multicenter Determinants of Myocardial Infarction Onset Study, who were interviewed during hospitalization for an AMI between 1989 and 1994.

The interview identified the time, place, and quality of AMI, as well as the estimated usual frequency of exposure to potential triggers of AMI onset during the previous year. In addition, patients were asked, "During the past year, did you hear news of the death of a friend, relative, or someone who was very significant in your life?"

If the patients answered affirmatively, they were asked to identify the time of occurrence of the death, their relationship to the person who died, and to rate the significance of this death in terms of meaningfulness: slightly, moderately, or extremely meaningful.

The researchers then compared the patient's report of the loss of a significant person in the days before AMI onset (case period) with the same patient's report of bereavement for a significant person in their life during the previous 6 months (control period).

Overall, 270 (13.6%) patients experienced the loss of a significant person in the previous 6 months, including 19 within 1 day of their AMI.

Of the 193 who provided details about the decedent, 153 patients had grieved the loss of a distant relative or friend, 20 a sibling, 12 a parent, six a spouse, and two a child.

Among the 19 patients who reported the death of a significant person within 24 hours of AMI onset, 12 (63%) rated the significance of this death moderately or extremely meaningful.

The rate of acute AMI onset was significantly increased 21.1-fold within 24 hours of learning of the death of a significant person. This risk declined but remained significantly elevated for at least 1 month after the death.

The absolute risk for AMI within 1 week of the death of a significant person was one excess AMI per 1394 individuals at low 10-year baseline AMI risk (5%; based on Framingham risk score) and one per 320 among individuals at high 10-year risk (20%).

"Friends and family of bereaved people should provide close support to help prevent such incidents, especially near the beginning of the grieving process," said Mostofsky in a press statement.

Co-author Murray Mittleman, also from Harvard Medical School, added: "Caretakers, healthcare providers, and the bereaved themselves need to recognize they are in a period of heightened risk in the days and weeks after hearing of someone close dying."

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Piriya Mahendra

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