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Heart attack risk rises after loss of loved one

BOSTON A person's risk of suffering a heart attack increases by approximately 21 times in the first 24 hours after losing a loved one, according to a study lead by researchers at Beth Israel Deaconess Medical Center.

The study published Jan. 9 online in the journal Circulation found the risk of heart attack remained eight times above normal during the first week after the death of a loved one, slowly declining, but remaining elevated for at least a month.

Researchers interviewed approximately 2,000 patients who suffered myocardial infarctions, or heart attacks, over a five-year period. Patients were asked a series of questions about potentially triggering events, including losing someone close to them in the past year.

While there is widespread anecdotal evidence that the death of a loved one can lead to declining health in survivors, few studies have looked at the acute effect of bereavement and grief on myocardial infarction.

"Bereavement and grief are associated with increased feelings of depression, anxiety and anger, and those have been shown to be associated with increases in heart rate and blood pressure, and changes in the blood that make it more likely to clot, all of which can lead to a heart attack," says lead author Elizabeth Mostofsky, MPH, ScD, a post-doctoral fellow in the cardiovascular epidemiological unit at BIDMC.

"Some people would say a 'broken heart' related to the grief response is what leads to these physiologic changes," says senior author Murray Mittleman, MD, DrPH, a physician in the Cardiovascular Institute at Beth Israel Deaconess Medical Center, an Associate Professor of Medicine at Harvard Medical School and director of BIDMC's cardiovascular epidemiological research program. "So that emotional sense of the broken heart may actually lead to damage leading to a heart attack and a physical broken heart of a sort."

Mostofsky and Mittleman think that being aware of the heightened risk can go a long way toward "breaking the link between the loss of someone close and the heart attack."

"Physicians, patients and families should to be aware of this risk and make sure that someone experiencing grief is getting their physical and medical needs met," says Mittleman. "And if an individual develops symptoms that we're concerned might reflect the beginnings of heart attack, we really need to take it very seriously and make sure that that patient gets appropriate evaluation and care."

Providing appropriate psychological interventions for someone who is grieving is also important. Mostofsky says, "We do think it's plausible that social support during that increased time of vulnerability would help mitigate the risk of heart attack."

Contact: Jerry Berger
Beth Israel Deaconess Medical Center

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