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Death of a partner linked to high risk for MI, stroke
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The death of a partner may be linked to increased risk for acute major CV events within the immediate weeks and months after bereavement, according to a new report.
“Understanding psychosocial factors associated with acute cardiovascular events may provide opportunities for prevention and improved clinical care,” Iain M. Carey, MSc, PhD, of St. George’s University of London, and colleagues wrote.
Researchers conducted a matched cohort study using a U.K. primary care database that included data from February 2005 to September 2012. They identified 30,447 individuals aged 60 to 89 years at baseline who experienced partner bereavement; participants were then matched by age, sex and general practice with a control group of 83,588 non-bereaved individuals.
The bereaved group had a higher rate of fatal or nonfatal MI or stroke within 30 days of bereavement compared with the non-bereaved group during the same period (0.16% vs. 0.08%; incidence rate ratio=2.2; 95% CI, 1.52-3.15).
The elevated risk for acute major CV events was observed in bereaved men and women, and was attenuated after 30 days, according to the researchers.
When the researchers examined individual outcomes, the 30-day elevated risk was present for MI alone (IRR=2.14; 95% CI, 1.2-3.81) and for stroke alone (IRR=2.4; 95% CI, 1.22-4.71).
Bereavement was also associated with rarer events, including increased risk for non-MI ACS (IRR=2.2; 95% CI, 1.12-4.29) and pulmonary embolism (IRR=2.37; 95% CI, 1.18-4.75) in the first 90 days after a partner’s death, compared with the non-bereaved group.
One explanation for these findings is “psychosocial triggers of acute cardiovascular events,” including “short-term changes in [BP], cortisol levels, heart rate variability, platelet activation and clotting factor levels,” Carey and colleagues wrote. “Our novel findings on [pulmonary embolism] further support the hypothesis that bereavement predisposes individuals to a prothrombotic state.”
Another factor may be that “during the period around the death of a loved one, patients may neglect their own health care needs, which may place them at greater risk for adverse cardiovascular events.”
Disclosure: The researchers report no relevant financial disclosures.
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