Newswise – Heart failure patients who are grieving or grieving after the loss of a close family member are at increased risk of death, especially during the first week after the family member’s death, according to a study published today in JACC: Heart Failure†
Heart failure (HF) affects more than 64 million people worldwide. Previous research results suggest that depression, anxiety and low social support are associated with a poor prognosis in HF patients. Many studies have also been conducted to confirm the relationship between severe emotional stress and Takotsubo cardiomyopathy, also known as “broken heart syndrome.” This study is one of the first to examine the association between bereavement and HF risk.
The study authors looked at nearly 500,000 patients from the Swedish Heart Failure Registry during 2000-2018 and/or patients with a primary diagnosis of HF from the Swedish Patient Register in 1987-2018. Information about the date and cause of death of relatives (children, spouse, grandchildren, siblings and parents) is obtained from the Cause of Death Register. A total of 58,949 study participants experienced a death during the mean follow-up of 3.7 years. The study authors analyzed whether relationship to the deceased, cause of death, or time elapsed since death affected HF mortality risk.
The association between bereavement and increased HF mortality risk was observed after the death of a child (a 10% increased risk), spouse/partner (a 20% increased risk), grandchild (a 5% increased risk), or sibling (a 13% increased risk). increased risk). risk), but not after the death of a parent. The risk of dying from HF after the loss of a family member was highest during the first week of bereavement (a 78% increased risk), especially in the case of death of a child (a 31% increased risk) or spouse/partner (an 113% increased risk); it was also higher in the case of two losses (a 35% increased risk) as opposed to one loss (a 28% increased risk).
“The association between bereavement and death was observed not only in cases of loss from cardiovascular disease and other natural causes, but also in cases of unnatural death,” said Hua Chen, the study’s lead author and a doctoral student at the Karolinska Institutet in Stockholm, Sweden. “Our finding that bereavement was associated with mortality in HF patients adds to and expands the existing literature regarding the role of stress in the prognosis of HF and is consistent with studies reporting associations between bereavement and increased risk of incident cardiovascular disease.”
The study authors said grief processing can activate the hypothalamic-pituitary-adrenal (HPA) axis, an important neuroendocrine system that regulates stress and emotional response. The authors said it may also trigger a response in the renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system, both of which are key features of the neuroendocrine response in HF.
“The study’s findings may require greater attention from family members, friends, and concerned professionals for heart failure patients, especially in the period shortly after the loss,” said Krisztina László, the study’s senior author and an associate professor in the Department of Global Public Health. at the Karolinska Institutet.
The study has several limitations, including that the authors were unable to eliminate the confounding effects of genetic factors or unmeasured socioeconomic, lifestyle, or health-related factors shared by family members. The authors had limited ability to detect effects in some of the sub-analyses, and the findings can only be generalized to countries with social and cultural contexts and health-related factors similar to Sweden. Future studies are needed to investigate whether less severe sources of stress may also contribute to a poor HF prognosis.
The American College of Cardiology envisions a world in which innovation and knowledge optimize cardiovascular care and outcomes. As a professional home for the entire cardiovascular care team, the mission of the College and its more than 56,000 members is to transform cardiovascular care and improve heart health. The ACC grants credentials to cardiovascular professionals who meet rigorous qualifications and lead in the formation of health policies, standards, and guidelines. The College also provides professional medical education, disseminates cardiovascular research through its world-renowned JACC Journals, operates national registries to measure and improve care, and provides cardiovascular accreditation to hospitals and institutions. For more go to acc.org†
The ACC family of JACC Magazines are among the best cardiovascular journals in the world for scientific impact. The flagship magazine, the Journal of the American College of Cardiology (JACC) — and family of specialist journals consisting of JACC: Advances, JACC: Asia, JACC: Basic to Translational Science, JACC: CardioOncology, JACC: Cardiovascular Imaging† JACC: Cardiovascular Interventions† JACC: Case Reports, JACC: Clinical Electrophysiology and JACC: Heart Failure – pride themselves on publishing the best peer-reviewed research on all aspects of cardiovascular disease. More information on JACC.org†
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