Haemodynamic Changes During Early Bereavement: Potential Contribution to Increased Cardiovascular Risk

• Published in: Heart, lung & circulation Vol. 20; no. 2; pp. 91 - 98
• Main Authors: Buckley, Thomas, PhD, Mihailidou, Anastasia Susie, PhD, Bartrop, Roger, MD, McKinley, Sharon, PhD, Ward, Christopher, PhD, Morel-Kopp, Marie-Christine, PhD, Spinaze, Monica, Dip.N, Tofler, Geoffrey H, MBBS, MD
• Format: Journal Article
• Language: English
• Published: Australia Elsevier B.V 01.02.2011
• Subjects: 24-h ambulatory blood pressure; Adult; Aged; Aged, 80 and over; Bereavement; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Cardiovascular; Cardiovascular Diseases - etiology; Cardiovascular Diseases - physiopathology; Cohort Studies; Female; Heart Rate; Humans; Male; Middle Aged; Prospective Studies; Psychosocial trigger; Risk Factors; Time Factors; Heart rate; 24-h ambulatory blood pressure; Bereavement; Psychosocial trigger
• ISSN: 1443-9506; 1444-2892
• DOI: 10.1016/j.hlc.2010.10.073

Background Bereavement is associated with increased cardiovascular risk, particularly in surviving spouses and parents, however the mechanism is not well understood due to limited studies. The purpose of this study was to evaluate haemodynamic changes (blood pressure (BP) and heart rate (HR)), that may contribute to increased cardiac risk in early bereavement. Methods We enrolled 80 bereaved individuals and 80 non-bereaved as a reference group. Twenty-four hour ambulatory blood pressure monitoring was performed within two weeks (acute assessment) and at six months following bereavement. Results Compared to the non-bereaved, the acutely bereaved had higher 24-hour systolic BP (mean (SE) 130.3 (1.5) vs 127.5 (1.4) mm Hg, p = 0.03), higher daytime systolic BP (135.6 (1.5) vs 131.6 (1.4) mm Hg, p = 0.02) and higher daytime systolic load (median % 39.0 vs 29.3, p = 0.02). By six months the BP of the bereaved tended to be lower than acute measures. This difference was significant amongst those not taking BP lowering medications for 24-hour systolic BP (126.5 (2.4) vs 129.7 (2.3) mm Hg, p = 0.04), daytime systolic BP (129.8 (2.1) vs 133.9 (2.0) mm Hg, p = 0.01) and daytime diastolic pressure (76.7 (1.0) vs 78.9 (0.9) mm Hg, p = 0.03). Twenty-four hour heart rate was also higher acutely in the bereaved compared with the reference group (74.0 (1.2) vs 71.7 (0.9) b/min, p = 0.02); at six months heart rate in the bereaved had fallen to non-bereaved levels (70.4 (0.09), p = 0.02). Conclusion Early bereavement is associated with increased systolic blood pressure and heart rate. These haemodynamic changes may contribute to a time-limited increase in cardiovascular risk.