Bereavement may up risk of heart attack, stroke

The death of a life partner may increase a person’s risk for a heart attack, stroke or other major cardiovascular event within a few weeks of the loss, according to a study published online Feb. 24 in JAMA Internal Medicine.

There has long been an association between the time shortly after bereavement and an increased risk of major cardiovascular events. Researchers led by Iain M. Carey, MSc, PhD, of St. George’s University in London, set out to determine the incidence of MI, stroke, acute coronary syndrome (ACS) and pulmonary embolism (PE) after a partner’s death.

Using information from 2005 through 2008 from a United Kingdom-wide primary database, they identified 171,720 heterosexual couples older than 60 years old with an age difference of 10 years or less and who never lived in a long-term care facility or a communal setting. They followed the couples until 2012 and based bereavement timing on information in the medical record.

They compared bereaved individuals with a control group of nonbereaved individuals who were matched for age, sex and practice. Ultimately, there were 30,447 bereaved participants with at least one matched control. An MI or a stroke within 30 days of bereavement served as the primary outcome.

Among the bereaved participants, 50 (0.16 percent) experienced an MI or a stroke compared with 67 of the nonbereaved (0.08 percent). Both men and women experienced an increased risk, and this risk was attenuated after 30 days. Individually, the incidence rate ratio (IRR) for MI was 2.14 and 2.4 for stroke. There was also an increased risk for non-MI acute coronary syndrome (IRR 2.2) and pulmonary embolism (IRR 2.37) in the first 90 days after bereavement.

They noted that bereavement may play a small overall role in raising the risk of a cardiovascular event because the death of a partner is generally a one-time event and the elevated risk is typically short term. 

However, they argued that “[u]nderstanding psychosocial factors associated with acute cardiovascular events may provide opportunities for prevention and improved clinical care.”