Medication may prevent 'broken heart' during bereavement

Friday, 14 February, 2020

Medication may prevent 'broken heart' during bereavement

The increased risk of heart attack or ‘a broken heart’ in early bereavement could be reduced by using common medication in a novel way, according to a study led by the University of Sydney.

Lead investigator Professor Geoffrey Tofler said while most people gradually adjust to the loss of a loved one, there is an increased risk of heart attack and death among bereaved people (particularly those grieving a spouse or child) — one that can last up to six months.

“It is highest in the first days following bereavement and remains at four times the risk between seven days to one month after the loss,” said Prof Tofler, Professor of Preventative Cardiology at the University of Sydney and Senior Staff Cardiologist at Royal North Shore Hospital. “Bereavement following the death of a loved one is one of the most stressful experiences to which almost every human is exposed.”

With this in mind, researchers from the University of Sydney, Royal North Shore Hospital and the Kolling Institute conducted what they claim is the first randomised controlled clinical trial to show it is possible to reduce several cardiac risk factors during this time, without adversely affecting the grieving process. Their study was published in the American Heart Journal.

The team enrolled 85 spouses or parents in the study within two weeks of losing their family member. 42 participants received low daily doses of a beta blocker and aspirin for six weeks, while 43 were given placebos. Heart rate and blood pressure were carefully monitored, and blood tests assessed blood clotting changes.

“The main finding was that the active medication, used in a low dose once a day, successfully reduced spikes in blood pressure and heart rate, as well as demonstrating some positive change in blood clotting tendency,” Prof Tofler said.

The investigators also carefully monitored the grief reaction of participants. Prof Tofler said, “We were reassured that the medication had no adverse effect on the psychological responses, and indeed lessened symptoms of anxiety and depression. Encouragingly, and to our surprise, reduced levels of anxiety and blood pressure persisted even after stopping the six weeks of daily beta blocker and aspirin.”

Co-investigator Associate Professor Tom Buckley, also from the University of Sydney, said the study builds on the team’s novel work in this area with their earlier studies among the first to identify the physiological correlates of bereavement, stating, “While beta blockers and aspirin have been commonly used long term to reduce cardiovascular risk, they have not previously been used in this way as a short-term preventative therapy during bereavement.”

The authors acknowledge that larger long-term studies are needed to identify who would benefit most; however, the findings provide encouragement for healthcare professionals to consider this simple and inexpensive preventative strategy among individuals who they consider to be at high risk associated with early bereavement.

“Our finding on the potentially protective benefit of this treatment is also a good reminder for clinicians to consider the wellbeing of the bereaved,” Assoc Prof Buckley said. “Future studies are needed to assess if these medications could be used for other short periods of severe emotional stress, such as after natural disasters or mass bereavement, where currently there are no guidelines to inform clinicians.”

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