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Cited by 158Grief, Bereavement, and Mental HealthCardiac Health and Mental HealthDeath, Funerary Practices, and Mourning

Increased Risk of Acute Cardiovascular Events After Partner Bereavement: A Matched Cohort Study

Carey, Iain M., Shah, Sunil M., DeWilde, Stephen, Harris, Tess, Victor, Christina R., Cook, Derek G.·2014·JAMA Internal Medicine
DOI 10.1001/jamainternmed.2013.14558
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Abstract

IMPORTANCE The period immediately after bereavement has been reported as a time of increased risk of cardiovascular events. However, this risk has not been well quantified, and few large population studies have examined partner bereavement. OBJECTIVE To compare the rate of cardiovascular events between older individuals whose partner dies with those of a matched control group of individuals whose partner was still alive on the same day. DESIGN, SETTING, AND PARTICIPANTS Matched cohort study using a UK primary care database containing availale data of 401 general practices from February 2005 through September 2012. In all, 30 447 individuals aged 60 to 89 years at study initiation who experienced partner bereavement during follow-up were matched by age, sex, and general practice with the nonbereaved control group (n = 83 588) at the time of bereavement. EXPOSURES Partner bereavement. MAIN OUTCOMES AND MEASURES The primary outcome was occurrence of a fatal or nonfatal myocardial infarction (MI) or stroke within 30 days of bereavement. Secondary outcomes were non-MI acute coronary syndrome and pulmonary embolism. All outcomes were compared between the groups during prespecified periods after bereavement (30, 90, and 365 days). Incidence rate ratios (IRRs) from a conditional Poisson model were adjusted for age, smoking status, deprivation, and history of cardiovascular disease. RESULTS Within 30 days of their partner's death, 50 of the bereaved group (0.16%) experienced an MI or a stroke compared with 67 of the matched nonbereaved controls (0.08%) during the same period (IRR, 2.20 [95% CI, 1.52-3.15]). The increased risk was seen in bereaved men and women and attenuated after 30 days. For individual outcomes, the increased risk was found separately for MI (IRR, 2.14 [95% CI, 1.20-3.81]) and stroke (2.40 [1.22-4.71]). Associations with rarer events were also seen after bereavement, including elevated risk of non-MI acute coronary syndrome (IRR, 2.20 [95% CI, 1.12-4.29]) and pulmonary embolism (2.37 [1.18-4.75]) in the first 90 days. CONCLUSIONS AND RELEVANCE This study provides further evidence that the death of a partner is associated with a range of major cardiovascular events in the immediate weeks and months after bereavement. Understanding psychosocial factors associated with acute cardiovascular events may provide opportunities for prevention and improved clinical care.

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  • Within 30 days of bereavement, there is an elevated risk for heart attack and stroke, along with alterations to immune function that are linked to the severity of anxiety and depressive symptoms.

    “Within 30 days of bereavement, there is an elevated risk for heart attack and stroke, along with alterations to immune function that are linked to the severity of anxiety and depressive symptoms [172,173] (Figure 2f).”

    From The Neurobiology of Love and Pair Bonding from Human and Animal Perspectives (2023) · cites this paper as [172]

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Authors
Carey, I. M., Shah, S. M., DeWilde, S., Harris, T., Victor, C. R., & Cook, D. G.
Affiliations
  • University of London (GB)
  • Brunel University of London (GB)
Corresponding author
Shah, Sunil M.
ORCID
Venue
JAMA Internal Medicine
Publisher
American Medical Association (AMA)
Published
2014-04-01
Volume
174
Issue
4
Pages
598
ISSN
2168-6106 (ISSN-L)
DOI
10.1001/jamainternmed.2013.14558
OpenAlex
W2115570811
Cited by
158
References
39
Citations by year
2026: 12 · 2025: 13 · 2024: 11 · 2023: 23 · 2022: 15 · 2021: 13 · 2020: 16 · 2019: 12 · 2018: 12 · 2017: 15 · 2016: 7 · 2015: 1 · 2014: 7
FWCI
11.80
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Social Sciences › Anthropology › Death, Funerary Practices, and Mourning
Keywords
partner bereavement, widowhood, acute cardiovascular events, myocardial infarction, stroke, acute coronary syndrome, pulmonary embolism, older adults, primary care
MeSH terms
Aged, Aged, 80 and over, Bereavement, Cardiovascular Diseases, Female, United Kingdom, Humans, Male, Myocardial Infarction, Pulmonary Embolism, Risk, Case-Control Studies, Spouses, Stroke, Acute Coronary Syndrome

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