Bereavement may increase HF mortality risk
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The death of a close family member was associated with increased risk for death among people with HF, with risk highest during the first week after the loss, according to findings from a Swedish register-based study.
“The findings of the study may call for increased attention from family members, friends and involved professionals for bereaved HF patients, particularly in the period shortly after the loss,” Krisztina László, PhD, associate professor of epidemiology at the Karolinska Institutet in Stockholm, told Healio. “Since this is one of the first studies in this field, we believe further studies are needed to better understand the role of stress in the prognosis of HF in order to inform clinical decision-making.”
László and colleagues analyzed data from the Swedish Heart Failure Registry from 2000 to 2018 and/or in the Swedish Patient Register of 490,527 patients with a primary diagnosis of HF from 1987 to 2018. Researchers used several population-based registers to assess information on death of close family members, defined as children, a partner, grandchildren, siblings and parents, as well as sociodemographic variables and health-related factors. Researchers used Poisson regression to determine the association between bereavement and mortality.
The findings were published in JACC: Heart Failure.
Within the cohort, 12% of registrants were exposed to bereavement during a mean 3.7 years of follow-up.
The death of a family member was associated with a 29% increased risk for dying (adjusted RR = 1.29; 95% CI, 1.27-1.3), with the association persisting for CV death, other natural deaths as well as unnatural death.
The risk was higher for two losses vs. one loss and highest in the first week after the loss (RR = 1.78; 95% CI, 1.61-1.98) and persisted throughout follow-up, according to researchers. The association between bereavement and an increased mortality risk was observed for the death of a child, spouse/partner, grandchild and sibling; however, the association was not seen for the death of a parent.
“Though stress may be implicated in the prognosis of HF, very few studies have investigated this association,” Hua Chen, MSc, a doctoral student in the department of global public health at the Karolinska Institutet in Stockholm, told Healio. “In this study, we found that the loss of a close family member, one of the most severe sources of stress one may experience, is associated with an increased risk of mortality in HF. Future studies are needed to investigate whether less severe sources of stress may also contribute to poor prognosis in HF and to explore the mechanisms underlying this association.”
For more information:
Hua Chen, MSc, can be reached at hua.chen@ki.se.
Krisztina László, PhD, can be reached at krisztina.laszlo@ki.se.
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