11 Feb Two Common Drugs May Reduce Risk of Heart Attack During Grief

MedicalResearch.com Interview with:

Prof. Tofler

Prof. Geoffrey Tofler MBBS MB FRACP FACC
Professor of Preventative Cardiology, University of Sydney
Senior Staff Cardiologist, Royal North Shore Hospital
New South Wales, Australia

MedicalResearch.com: What is the background for this study?

Response: Bereavement due to the death of a loved one is one of the most stressful experiences to which almost every human is exposed. Grief is an unavoidable and natural reaction to the loss.  While in most people the grief reaction gradually diminishes, an increased risk of heart attack or has been described in the early weeks and months following bereavement.   Although this increase in heart attacks is well recognised, until now there have not been any previous studies to provide guidance on how to safely reduce the risk.

MedicalResearch.com: What are the main findings? 

Response: Our research team enrolled 85 bereaved spouses or parents within two weeks of losing their loved one to see if we could reduce increased physiological measures of risk we had found in our previous work.

The main finding was that the combination of 2 common medications (beta blocker and aspirin) we chose, reduced levels of blood pressure and heart rate, as well as showed some positive change in blood clotting tendency.   We were reassured that the medication had no adverse effect on the bereavement process and indeed lessened symptoms of anxiety and depression.  Encouragingly, the reduced levels of anxiety and blood pressure we found persisted even after stopping the 6 weeks of daily medication. 

MedicalResearch.com: What should readers take away from your report?

Response: While almost everyone loses someone they love during their lifetime, and grief is a natural reaction,  this stressful time can be associated with an increased risk of heart attack.  The bereaved should not neglect their health or  ignore symptoms that may be heart related. Family and friends should be supportive, at a time when focus is usually directed at the deceased person.   A medical check-up for the bereaved is helpful.  While most people gradually adjust,  the clinician is able to consider this treatment combination as an option in their individual patient. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: Larger long term studies are needed to identify who would benefit most, however  the findings provide encouragement for family doctors and other health care professionals to consider this preventive approach among people they consider to be at high risk associated with bereavement.  This treatment combination (beta blocker and aspirin) could be investigated for other short periods of severe emotional stress. 

Any disclosures?

The study was funded by Heart Research Australia.  The study protocol was approved by the Institutional Review Board of North Sydney Health Ethics Committee, Australia.  The authors declare no competing interests. People experiencing potential cardiac symptoms should discuss their condition with a health professional before taking medication as incorrect use could be harmful. 

Citation:

Geoffrey H. Tofler, Marie-Christine Morel-Kopp, Monica Spinaze, Jill Dent, Christopher Ward, Sharon McKinley, Anastasia S. Mihailidou, Jennifer Havyatt, Victoria Whitfield, Roger Bartrop, Judith Fethney, Holly G. Prigerson, Thomas Buckley,

The effect of metoprolol and aspirin on cardiovascular risk in bereavement: A randomized controlled trial,
American Heart Journal, Volume 220, 2020, Pages 264-272,

ISSN 0002-8703,
https://doi.org/10.1016/j.ahj.2019.11.003 

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Last Updated on February 11, 2020 by Marie Benz MD FAAD