How Does Bereavement Increase Cardiac Risk?

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There is now a lot of research that indicates emotional stress in certain people can increase cardiac risk. Chronic emotional stress can increase a person's odds of developing heart disease, while episodes of acute emotional stress can precipitate acute cardiac crises, such as acute coronary syndrome.

Recently, investigators have begun to clarify the type and degree of cardiac risk associated with a particular kind of emotional stress that, eventually, is experienced by almost everybody - bereavement over the death of a loved one.

How Does Bereavement Affect the Heart?

We have all heard stories about, and may even have personal experience with, a person who has a heart attack, or develops some other severe illness, or even dies, within a few days of the death of a beloved spouse.

Scientists have now confirmed what most of us have long believed - these sad events are more than mere coincidence.

When a person experiences intense grief, a number of changes occur within the body. These include higher adrenaline levels (leading to an increased heart rate and blood pressure), lack of sleep, poor appetite, and changes in hormone levels (such as cortisol) that can affect the cardiovascular system. During bereavement people are also prone - through forgetfulness or apathy - to stop taking their medication.

How Large Is the Risk?

Recently, investigators have learned that such grief-induced changes are associated with an astounding increase in the risk of heart attack. During the first 24-hours of the bereavement period, the risk of heart attack is increased 21-fold, and the risk remains substantially elevated (5 - 10 times normal) for at least a week or two after a loved one has died.

Who Is Most At Risk?

For obvious reasons, the acute increase in cardiovascular risk that occurs with bereavement is especially significant in anyone who already has cardiovascular disease - or whose risk factors have placed them into a high-risk category.
    The acute bereavement-related risk also depends, to some degree, on the caregiver role the survivor played prior to the death of his/her loved one. It turns out that the acute increase in risk is actually higher for survivors who did not fulfill an active, stressful caregiver role. Apparently, this is because the stress of providing difficult long-term care to a loved one is so high that - even when the acute grief at their death is factored in - the caregiver may very well have a net improvement in their health when the caregiver obligations are suddenly removed.


    If a friend or loved one is going through a period of bereavement, there are several things you should keep in mind.

    First and foremost, their cardiac risk will be much higher for a period of time - especially in the first few days or weeks. You can help to reduce that risk by making sure they are eating adequately, getting some rest, and taking all their medications.

    Second, it turns out that caregivers are bolstered when friends and loved ones help with funeral arrangements and post-funeral reception, spend time with the surviving loved ones, and doing the little things to help them ease into this new phase of their live - such as taking them a casserole, or bringing in the newspapers and mail. Basically, just let them know that they really aren't alone, and that eventually, life will go on.

    All these traditional, loving actions help to alleviate the acute heart-threatening stress people often experience during periods of intense personal grief.


    Mostofsky E, Maclure M, Sherwood JB, et al. Risk of acute myocardial infarction after the death of a significant person on one's life. The determinants of myocardial infarction onset study. Circulation 2012; DOI: 10.1161/CIRCULATIONAHA.111.061770.

    Schulz R, Beach SR, Lind B. Involvement in Caregiving and Adjustment to Death of a Spouse: Findings From the Caregiver Health Effects Study JAMA. 2001;285(24):3123-3129.

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