In the first days after a death, arrange company, continue prescribed medicines, and treat chest pressure as an emergency
One study found that heart attack onset was 21.1 times more frequent in the first day after the death of someone important, then declined day by day. Another found roughly double the rate of heart attack or stroke in bereaved partners aged 60–89 during the first 30 days. If you already have cardiovascular disease, do not stop treatment. Chest pressure, severe breathlessness, or one-sided weakness warrants an immediate emergency call—120 in China.
What it takes
Nothing to arrange support. Keep taking prescribed medicines and avoid being alone where possible.
What you may gain
A case-crossover study examined 1,985 acute myocardial infarction patients, comparing different periods within the same person. Of these, 270, or 13.6%, had lost someone significant during the preceding six months, and 19 during the day before the infarction. Heart attack incidence in the 24 hours after the death was 21.1 times the comparison rate, 95% CI 13.1–34.1, and declined on subsequent days. Estimated excess risk was one additional event per 1,394 bereaved people with a 5% ten-year heart attack risk and one per 320 with a 20% ten-year risk. A UK study compared 30,447 bereaved partners aged 60–89 with 83,588 matched controls. During the first 30 days, heart attack or stroke occurred in 50 bereaved participants, 0.16%, and 67 controls, 0.08%, IRR 2.20, 95% CI 1.52–3.15. For heart attack alone the IRR was 2.14, 1.20–3.81, and for stroke 2.40, 1.22–4.71. The association weakened after 30 days. During 90 days, non-infarction acute coronary syndrome—an acute heart-blood-supply problem falling short of a heart attack—had IRR 2.20, 1.12–4.29, and pulmonary embolism—a clot obstructing a lung blood vessel—IRR 2.37, 1.18–4.75.
Context & considerations
Ask someone to help organize medicines instead of relying on memory. Avoid long-distance driving in the immediate aftermath, and do not use alcohol to cope; see chapter 2. For recognizing heart attack or stroke and calling emergency services, see chapter 13. Both studies used observational data and cannot fully establish how many events would have happened anyway, but they point to a similar period of increased risk. If nobody is available to help, see entry 6.
Research & references
Mostofsky E et al. (2012). Risk of acute myocardial infarction after the death of a significant person in one's life: the Determinants of Myocardial Infarction Onset Study. Circulation. https://doi.org/10.1161/CIRCULATIONAHA.111.061770; Carey IM et al. (2014). Increased risk of acute cardiovascular events after partner bereavement: a matched cohort study. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2013.14558