Researchers at Beth Israel Deaconess Medical Center and Harvard School of Public Health have learned that newly grieving or bereaved individuals are at 21 times the normal risk of a heart attack in the first 24 hours following the loss of a significant person. Although this risk drops over time, after a week it is still greatly elevated and even after a month the risk remains well above average, the NIH-supported investigators have shown.
Results from the Determinants of MI Onset Study were published in the American Heart Association’s journal Circulation. The work was funded by NHLBI and NIAID.
The researchers interviewed some 2,000 cardiac patients, all of whom were in the hospital for a heart attack. Findings revealed that while the overall risk for heart attack (myocardial infarction or MI) was greatest over the first 24-hour period following the loss, there was still an 8-fold likelihood of MI occurrence a week after the death of a significant social contact. After a month, that number was halved. Overall, 270 people experienced a heart attack within 6 months of the loss of another, while 19 people had lost a close acquaintance or loved one the day before having an MI.
The findings hold clinical implications for the bereaved, their family members and health workers, according to lead investigator and epidemiologist Dr. Elizabeth Mostofsky.
In terms of stressful life events, the death of a family member or close acquaintance ranks high. The loss of a spouse ranks first, according to the Holmes-Rahe Life Stress Inventory, well ahead of the second leading stressor, divorce. The loss of another family member rates fourth.
It is well documented that adverse stress, especially abrupt or acute stress, can have detrimental effects on both mind and body, provoking various somatic (bodily) complaints (headache, muscular tension and discomfort, stomach ailments, etc.). Until now, however, there have been no studies to examine the acute effects of bereavement on MI risk.
A survivor’s life can be turned upside down after the loss of a spouse or significant other. Following the loss, the survivor “may experience feelings of depression, anxiety and anger, stressors that may lead to physiologic sequelae such as higher blood pressure and heart rate and more blood clotting that increase the risk of a heart attack,” noted Mostofsky.
What stood out prominently in the study was the robust nature of the findings, in particular that the effects were so dramatic and can occur so quickly following an individual’s loss, according to the scientists.
“Here is an opportunity for family members and clinicians to intervene and make a difference,” Mostofsky said. The take-home message? “It is very important that bereaved individuals take special care of themselves during the grieving process. For instance, they [and their supporting family members] should make sure to take their medicines and get ample rest,” she concluded.— Jan Ehrman