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Grief over losing loved one heightens MI risk
Mostofsky E. Circulation. 2012;doi:10.1161/CIRCULATIONAHA.111.061770.
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Risk for MI appears to increase in the days and weeks after the death of a significant person in one’s life, according to researchers.
The relationship between grief and MI risk may have an even greater effect among those at high CV risk, they said.
“Caretakers, health care 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,” Murray Mittleman, MD, DrPH, preventive cardiologist and epidemiologist at Harvard Medical School’s Beth Israel Deaconess Medical Center, said in a press release.
As part of the multicenter Determinants of Myocardial Infarction Onset Study, researchers reviewed charts and interviewed patients while in the hospital after a confirmed MI between 1989 and 1994. Patients answered questions about circumstances surrounding their MI, as well as whether they recently lost someone significant in their lives during the past year, when the death happened and the importance of their relationship. The researchers estimated the RR for an MI by comparing the number of patients who had someone close to them die in the week before their MI with the number of deaths of significant people in their lives from 1 to 6 months before their MI.
Six months before the loss of a significant person, 13.6% of the study population (n=1,985; 590 women; mean age, 61.6 years) experienced MI; 19 experienced MI within 24 hours after the loss. The incidence rate of acute MI onset was elevated more than 21-fold (95% CI, 13.1-34.1) within 24 hours of the death of a significant person; it declined steadily on each subsequent day (IRR after 1 week=5.8; 95% CI, 3.7-9.2). Within 1 week of the death of a significant person, the absolute calculated risk for MI was one excess MI per 1,394 exposed people at low 10-year MI risk and one per 320 among those at high 10-year risk.
“These results require confirmation in prospective studies,” Mittleman and colleagues wrote.
“Although it cannot be tested easily in a randomized clinical trial, it seems plausible that providing social support at the time of bereavement may help mitigate the heightened risk,” the researchers concluded. “Another approach is to consider the use of preventive agents to address hemodynamic and thrombosis-related changes. The data were collected before common use of statins. Future research could examine whether the risk is mitigated with regular statin use.”
Disclosure: Dr. Mittleman and colleagues report no relevant financial disclosures.
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