Skip to main content
SpringerLink
Log in

Bereavement and the Risk of Cardiovascular Disease

  • Reference work entry
  • First Online:
Handbook of Psychocardiology

Abstract

“The doctor died unexpectedly at home. His wife of 45 years passed away 4 days previously. He was known for his professional, surgical expertise, and his compassionate care for patients and their families.” From a notice in a local paper.

The death of a loved one has long been known to convey an adverse health risk, including increased cardiac events, although the mechanisms remain uncertain. While the mortality risk appears to be greatest in the initial weeks following bereavement, it remains significantly elevated during the first 6 months. Despite the difficulties conducting studies at this time, early bereavement has been associated with neuroendocrine activation, hemodynamic and prothrombotic changes, altered sleep, and immune imbalance, all of which may contribute to increased cardiovascular risk. Further research, based on an understanding of the underlying mechanisms and identified physiological changes, is required to pursue the goal of reducing health risk during this major life stress.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 599.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 799.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Armitage, R., & Hoffmann, R. (2001). Sleep EEG, depression and gender. Sleep Medicine Reviews, 5, 237–246.

    Article  PubMed  Google Scholar 

  • Baer, D. J., Judd, J. T., Clevidence, R. A., Muesing, R. A., Campbell, W. S., Brown, E. D., et al. (2002). Moderate alcohol consumption lowers risk factors for cardiovascular disease in postmenopausal women fed a controlled diet. American Journal Clinical Nutrition, 75, 593–599.

    Google Scholar 

  • Bartrop, R. W., Luckhurst, E., Lazarus, L., Kiloh, L. G., & Penny, R. (1977). Depressed lymphocyte function after bereavement. Lancet, 1(8016), 834–836.

    Article  PubMed  Google Scholar 

  • Benninghoven, D., Kaduk, A., Wiegand, U., Specht, T., Kunzendorf, S., & Jantschek, G. (2006). Influence of anxiety on the course of heart disease after acute myocardial infarction – risk factor or protective function. Psychotherapy and Psychosomatics, 75, 56–61.

    Article  PubMed  Google Scholar 

  • Bigger, J. T., Jr., Steinman, R. C., Rolnitzky, L. M., Fleiss, J. L., Albrecht, P., & Cohen, R. J. (1996). Power law behaviour of RR-interval variability in healthy middle-aged persons, patients with recent acute myocardial infarction, and patients with heart transplant. Circulation, 93, 2142–2151.

    Article  PubMed  Google Scholar 

  • Breier, A. (1989). A.E. Bennett award paper. Experimental approaches to human stress research: Assessment of neurobiological mechanisms of stress in volunteers and psychiatric patients. Biological Psychiatry, 26, 438–462.

    Article  PubMed  Google Scholar 

  • Buckley, T., Bartrop, R., McKinley, S., Ward, C., Bramwell, M., Roche, D., Miahilidou, A. S., Morel-Kopp, M.-C., & Spinaze, M. (2009). A prospective study of early bereavement on psychological and behavioural cardiac risk factors. International Medical Journal, 39, 370–378.

    Article  Google Scholar 

  • Buckley, T., McKinley, S., Tofler, G. H., & Bartrop, R. (2010). Cardiovascular risk in early bereavement: A literature review and proposed mechanisms. International Journal of Nursing Studies, 45, 229–238.

    Article  Google Scholar 

  • Buckley, T., Mihailidou, A., Bartrop, R., et al. (2011). Haemodynamic changes during early bereavement: Potential contribution to increased cardiovascular risk. Heart, Lung & Circulation, 20, 91–98.

    Article  Google Scholar 

  • Buckley, T., Morel-Kopp, M. C., Ward, C., Bartrop, R., McKinley, S., Mihailidou, A. S., Spinaze, M., Chen, W., & Tofler, G. (2012a). Inflammatory and thrombotic changes in early bereavement: A prospective evaluation. European Journal Prevention Cardiology, 19, 1145–1152.

    Article  Google Scholar 

  • Buckley, T., Stannard, A., Bartrop, R., McKinley, S., Ward, C., Mihailidou, A. S., Morel-Kopp, M.-C., Spinaze, M., & Tofler, G. (2012b). Effect of early bereavement on heart rate and heart rate variability. The American Journal of Cardiology, 110, 1378–1383.

    Article  PubMed  Google Scholar 

  • Bunker, S. J., Colquhoun, D. M., & Esler, M. D. (2003). “Stress” and coronary heart disease: Psychosocial risk factors. The Medical Journal of Australia, 178, 272–276.

    PubMed  Google Scholar 

  • Christakis, N. A., & Iwashyna, T. J. (2003). The health impact of health care on families: A matched cohort study of hospice use by decedents and mortality outcomes in surviving, widowed spouses. Social Science and Medicine, 57, 465–475.

    Article  PubMed  Google Scholar 

  • Cumming, J., Olphin, T., & Law, M. (2007). Self-reported psychological states and physiological responses to different types of motivational general imagery. Journal of Sport & Exercise Psychology, 29, 629–644.

    Google Scholar 

  • Falaschi, P., Proietti, A., De Angelis, C., et al. (2003). Effects of mental stress on cardiovascular and endocrine response in Air Force Academy cadets. Neuro Endocrinology Letters, 24, 197–202.

    PubMed  Google Scholar 

  • Fredrickson, B. L., Maynard, K. E., MHElms, M. J., Haney, T. L., Siegler, J. C., & Barefoot, J. C. (2000). Hostility predicts magnitude and duration of blood pressure response to anger. Journal of Behavioral Medicine, 23, 229–243.

    Article  PubMed  Google Scholar 

  • Genevro, J. L., Marshall, T., & Miller, T. (2004). Report on bereavement and grief research. Death Studies, 28(6), 491–575.

    Article  PubMed  Google Scholar 

  • Gerra, G., Monti, D., Panerai, A., Sacerdote, P., Anderlini, R., Avanzini, P., Zaimovic, A., Brambilla, F., & Franceschi, C. (2003). Long-term immune-endocrine effects of bereavement: Relationships with anxiety levels and mood. Psychology Research, 121, 145–158.

    Google Scholar 

  • Glozier, N., Tofler, G. H., Colquhoun, D. M., Bunker, S. J., Clarke, D. M., Hare, D. L., Hickie, I. B., Tatoulis, J., Thompson, D. R., Wilson, A., & Branagan, M. G. (2013). Psychosocial risk factors for coronary heart disease. The Medical Journal of Australia, 199, 179–180.

    Article  PubMed  Google Scholar 

  • Goodenough, B., Drew, D., Higgins, S., & Trethewie, S. (2004). Bereavement outcomes for parents who lost a child to cancer: Are place of death and sex of parent associated with differences in psychological functioning. Psychooncology, 13, 779–791.

    Article  PubMed  Google Scholar 

  • Goodkin, K., Feaster, D. J., Tuttle, R., Blaney, N. T., Kumar, M., Baum, M. K., Shapshak, P., & Fletcher, M. A. (1996). Bereavement is associated with time-dependent decrements in cellular immune function in asymptomatic human immunodeficiency virus type 1-seropositive homosexual men. Clinical and Diagnostic Laboratory Immunology, 3, 109–118.

    PubMed  PubMed Central  Google Scholar 

  • Goodkin, K., Baldewicz, T. T., Asthana, D., Khamis, I., Blaney, N. T., Kumar, M., Burkhalter, J. E., Leeds, B., & Shapshak, P. (2001). A bereavement support group intervention affects plasma burden of human immunodeficiency virus type 1. Report of a randomized controlled trial. Journal of Human Virology, 4, 44–54.

    PubMed  Google Scholar 

  • Grant, I., Adler, K. A., Patterson, T. L., Dimsdale, J. E., Ziegler, M. G., & Irwin, M. R. (2002). Health consequences of Alzheimer’s caregiving transitions: Effects of placement and bereavement. Psychosomatic Medicine, 64, 477–486.

    Article  PubMed  Google Scholar 

  • Hart, C. L., Hole, D. J., Lawlor, D. A., Smith, G. D., & Lever, T. F. (2007). Effect of conjugal bereavement on mortality of the bereaved spouse in participants of the Renfrew/Paisley study. Journal Epidemiology and Communication Health, 61, 455–460.

    Article  Google Scholar 

  • Heidland, U. E., & Strauer, B. E. (2001). Left ventricular muscle mass and elevated heart rate are associated with coronary plaque disruption. Circulation, 104, 1477–1482.

    Article  PubMed  Google Scholar 

  • Horsten, M., Ericson, M., Perski, A., Wamala, S. P., Schenck-Gustafsson, K., & Orth-Gomer, K. (1999). Psychosocial factors and heart rate variability in healthy women. Psychosomatic Medicine, 61(1), 49–57.

    Article  PubMed  Google Scholar 

  • Irwin, M., Daniels, M., Risch, S. C., Bloom, E., & Weiner, H. (1988). Plasma cortisol and natural killer cell activity during bereavement. Biological Psychiatry, 24, 173–178.

    Article  PubMed  Google Scholar 

  • Irwin, M., Wang, M., Ribeiro, D., Cho, H. J., Olmstead, R., Breen, E. C., et al. (2006). Sleep loss activates cellular inflammatory signaling. Biological Psychiatry, 63, 538–540.

    Google Scholar 

  • Kawachi, I., Colditz, G. A., Ascherio, A., et al. (1994). Prospective study of phobic anxiety and risk of coronary heart disease in men. Circulation, 89(5), 1992–1997.

    Article  PubMed  Google Scholar 

  • Khanfer, R., Lord, J. M., & Phillips, A. C. (2011). Neutrophil function and cortisol: DHEAS ratio in bereaved older adults. Brain, Behavior, and Immunity, 25, 1182–1186.

    Article  PubMed  Google Scholar 

  • Kizilbash, M. A., Daviglus, M. L., Dyer, A. R., Garside, D. B., Hankinson, A. L., Yan, L. L., Tian, L., Van, L., Wang, R., & Greenland, P. (2008). Relation of heart rate with cardiovascular disease in normal-weight individuals: The Chicago Heart Association Detection Project in Industry. Preventive Cardiology, 11, 141–147.

    Article  PubMed  Google Scholar 

  • Kloner, R. A. (2006). Natural and unnatural triggers of myocardial infarction. Progress Cardiovascular Diseases, 48, 285–300.

    Article  Google Scholar 

  • Lichtenstein, P., Gatz, M., & Berg, S. (1998). A twin study of mortality after spousal bereavement. Psychological Medicine, 28, 635–643.

    Article  PubMed  Google Scholar 

  • Lichtman, J. H., Bigger, J. T., Jr., Blumenthal, J. A., et al. (2008). Depression and coronary heart disease: Recommendations for screening, referral, and treatment: A science advisory from the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research: Endorsed by the American Psychiatric Association. Circulation, 118, 1768–1775.

    Article  PubMed  Google Scholar 

  • Lindsay, J., Paixao, A., Chao, T., & Pichard, A. D. (2010). Pathogenesis of the takotsubo syndrome: A unifying hypothesis. The American Journal of Cardiology, 106, 1360–1363.

    Article  PubMed  Google Scholar 

  • Linn, M. W., Linn, B. S., & Jensen, J. (1984). Stressful events, dysphoric mood, and immune responsiveness. Psychological Reports, 54, 219–222.

    Article  PubMed  Google Scholar 

  • Maciejewski, P. K., Zhang, B., Block, S. D., & Prigerson, H. G. (2007). An empirical examination of the stage theory of grief. JAMA, 297, 716–723.

    Article  PubMed  Google Scholar 

  • Manor, O., & Eisenbach, Z. (2003). Mortality after spousal loss: Are there socio-demographic differences? Social Science & Medicine, 56, 405–413.

    Article  Google Scholar 

  • Martikainen, P., & Valkonen, T. (1996). Mortality after the death of a spouse: Rates and causes of death in a large Finnish cohort. American Journal of Public Health, 86, 1087–1093.

    Article  PubMed  PubMed Central  Google Scholar 

  • Miller, G. E., & Cohen, S. (2001). Psychological interventions and immune system: A meta-analytic review and critique. Health Psychology, 20, 47–63.

    Article  PubMed  Google Scholar 

  • Mittleman, M. A., Maclure, M., Sherwood, J. B., Mulry, R. P., Tofler, G. H., Jacobs, S. C., Friedman, R., Benson, H., & Muller, J. E. (1995). Triggering of acute myocardial infarction onset by episodes of anger. Determinants of Myocardial Infarction Onset Study Investigators. Circulation, 92, 1720–1725.

    Article  PubMed  Google Scholar 

  • Miyabayashi, S., & Yasuda, J. (2007). Effects of loss from suicide, accidents, acute illness and chronic illness on bereaved spouses and parents in Japan: Their general health, chronic depressive mood, and grief reaction. Psychiatry and Clinical Neurosciences, 61, 502–508.

    Article  PubMed  Google Scholar 

  • Moller, J., Hallqvist, J., Diderichsen, F., Theorell, T., Reuterwall, C., & Ahglbom, A. (1999). Do episodes of anger trigger myocardial infarction? A case-crossover analysis in the Stockholm Heart Epidemiology Program (SHEEP). Psychosomatic Medicine, 61, 842–849.

    Article  PubMed  Google Scholar 

  • Mor, V., McHorney, C., & Sherwood, S. (1986). Secondary morbidity among the recently bereaved. American Journal Psychology, 143, 158–163.

    Article  Google Scholar 

  • Morel-Kopp, M. C., McLean, L., Chen, Q., Tofler, G. H., Tennant, C., Maddison, V., & Ward, C. M. (2009). The association of depression with platelet activation: Evidence for a treatment effect. Journal of Thrombosis and Haemostasis, 7, 573–581.

    Article  PubMed  Google Scholar 

  • Mostofsky, E., Maclure, M., Sherwood, J. B., Tofler, G. H., Muller, J. E., & Mittleman, M. A. (2012). Death of a significant person increases the risk of acute myocardial infarction onset: The Determinants of MI Onset Study. Circulation, 125, 491–496.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mostovsky, E., Penner, E. A., & Mittleman, M. A. (2014). Outbursts of anger as a trigger of acute cardiovascular events: A systematic review and meta-analysis. European Heart Journal, 35(21), 1404–1410.

    Article  Google Scholar 

  • Nicolson, N. A. (2004). Childhood parental loss and cortisol levels in adult men. Psychoneuroendocrinology, 29, 1012–1018.

    Article  PubMed  Google Scholar 

  • O’Connor, M. F., Allen, J. J., & Kaszniak, A. W. (2002). Autonomic and emotion regulation in bereavement and depression. Journal of Psychosomatic Research, 52, 183–185.

    Article  PubMed  Google Scholar 

  • Parkes, C. M., Benjamin, B., & Fitzgerald, R. C. (1969). Broken heart: A statistical study of increased mortality among widowers. BMJ, 1(646), 740–743.

    Article  PubMed  PubMed Central  Google Scholar 

  • Prigerson, H. G., Maciejewski, P. K., Reynolds, C. F., 3rd, Bierhals, A. J., Newsom, J. T., Fasiczka, A., Frank, E., Doman, J., & Miller, M. (1995). Inventory of complicated grief: A scale to measure maladaptive symptoms of loss. Psychiatry Research, 59, 65–79.

    Article  PubMed  Google Scholar 

  • Richardson, S., Lund, D., Caserta, M., Dudley, W., & Obray, S. (2003). Sleep patterns in older bereaved spouses. Omega – Journal Death & Dying, 47, 361–383.

    Article  Google Scholar 

  • Ridker, P. M., Cushman, M., Stampfer, M. J., Tracy, R. P., & Hennekens, C. H. (1997). Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. The New England Journal of Medicine, 336, 973–979.

    Article  PubMed  Google Scholar 

  • Riemann, D., Berger, M., & Voderholzer, U. (2001). Sleep and depression – results from psychobiological studies: An overview. Biological Psychology, 57, 67–103.

    Article  PubMed  Google Scholar 

  • Rogowski, O., Shapira, I., SHirom, A., Melamed, S., Toker, S., & Berliner, S. (2007). Heart rate and microinflammation in men: A relevant atherothrombotic link. Heart, 93, 940–944.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rozanski, A., Blumenthal, J. A., & Kaplan, J. (1999). Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation, 99, 2192–2217.

    Article  PubMed  Google Scholar 

  • Santic, Z., Lukic, A., Sesar, D., Milicevic, S., & Ilakovac, V. (2006). Long-term follow-up of blood pressure in family members of soldiers killed during the war in Bosnia and Herzegovina. Croatian Medical Journal, 47, 416–423.

    PubMed  PubMed Central  Google Scholar 

  • Schaefer, C., Quesenberry, C. P., & Wi, S. (1995). Mortality following conjugal bereavement and the effects of a shared environment. American Journal of Epidemiology, 141, 1142–1152.

    PubMed  Google Scholar 

  • Schleifer, S. J., Keller, S. E., Camerino, M., Thornton, J. C., & Stein, M. (1983). Suppression of lymphocyte stimulation following bereavement. JAMA, 250, 374–377.

    Article  PubMed  Google Scholar 

  • Shahar, D. R., Schultz, R., Shahar, A., & Wing, R. R. (2001). The effect of widowhood on weight change, dietary intake and eating behaviour. Journal of Aging and Health, 13, 189–199.

    Article  PubMed  Google Scholar 

  • Spratt, M. L., & Denney, D. R. (1991). Immune variables, depression, and plasma cortisol over time in suddenly bereaved parents. The Journal of Neuropsychiatry and Clinical Neurosciences, 3, 299–306.

    Article  PubMed  Google Scholar 

  • Steptoe, A., Strike, P. C., Perkins-Porras, L., McEwan, J. R., & Whitehead, D. L. (2006). Acute depressed mood as a trigger of acute coronary syndromes. Biology Psychology, 60, 837–842.

    Article  Google Scholar 

  • Stroebe, M., Schut, H., & Stroebe, W. (2007). Health outcomes of bereavement. Lancet, 370, 1960–1973.

    Article  PubMed  Google Scholar 

  • Taylor, M. P., Reynolds, C. F., 3rd, Frank, E., Dew, M. A., Mazumdar, S., Houck, P. R., & Kupfer, D. J. (1999). EEG sleep measures in later-life bereavement depression. A randomized, double-blind, placebo-controlled evaluation of nortriptyline. American Journal Geriatric Psychiatry, 7, 41–47.

    Google Scholar 

  • Taylor, D. J., Lichstein, K. L., & Durrence, H. H. (2003). Insomnia as a health risk factor. Behavioral Sleep Medicine, 1, 227–247.

    Article  PubMed  Google Scholar 

  • Tofler, G. H., & Muller, J. E. (2006). Triggering of acute cardiovascular disease and potential preventive strategies. Circulation, 114, 1863–1872.

    Article  PubMed  Google Scholar 

  • Tofler, G. H., O’Farrell, A., & Buckley, T. (2012). Psychological triggers for plaque rupture. In P. Hjemdahl, A. Rosengren, & A. Steptoe (Eds.), Stress and cardiovascular disease. London: Springer.

    Google Scholar 

  • Virtanen, R., Jula, A., Salminen, J. K., Voipio-Pulkki, L. M., Helenius, H., Kuusela, T., et al. (2003). Anxiety and hostility are associated with reduced baroreflex sensitivity and increased beat-to-beat blood pressure variability. Psychosomatic Medicine, 65, 751–756.

    Article  PubMed  Google Scholar 

  • von Kanel, R., Hepp, U., Traber, R., Kraemer, B., Mica, L., Keel, M., Mausbach, B. T., & Schnyder, U. (2008). Measures of endothelial dysfunction in plasma of patients with posttraumatic stress disorder. Psychiatry Research, 158, 363–373.

    Article  Google Scholar 

  • Wang, J., Zhang, S., Jin, Y., Qin, G., Yu, L., & Zhang, J. (2007). Elevated levels of platelet-monocyte aggregates and related circulating biomarkers in patients with acute coronary syndrome. International Journal of Cardiology, 115, 361–365.

    Article  PubMed  Google Scholar 

  • Wittstein, I. S., Thiemann, D. R., Lima, J. A., et al. (2005). Neurohumoral features of myocardial stunning due to sudden emotional stress. The New England Journal of Medicine, 352, 539–548.

    Article  PubMed  Google Scholar 

  • Young, M., Benjamin, B., & Wallis, C. (1963). The mortality of widowers. Lancet, 13, 454–456.

    Article  Google Scholar 

  • Yusuf, S., Hawken, S., Ounpuu, S., et al. (2004). Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case-control study. Lancet, 364, 937–952.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Discipline of Psychiatry, Sydney Medical School-Northern, St Leonards, University of Sydney, Sydney, NSW, 2065, Australia

    Roger Bartrop

  2. Department of Mental Health, Blacktown-Mt Druitt Clinical School, School of Medicine, Western Sydney University, Sydney, NSW, Australia

    Roger Bartrop

  3. Sydney Nursing School, University of Sydney, Sydney, NSW, Australia

    Thomas Buckley

  4. Department of Cardiology, Royal North Shore Hospital, Sydney Medical School, University of Sydney, Westbourne Street, St. Leonards, Sydney, NSW, Australia

    Thomas Buckley & Geoffrey H. Tofler

Authors
  1. Roger Bartrop
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas Buckley
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Geoffrey H. Tofler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Roger Bartrop .

Editor information

Editors and Affiliations

  1. Monash Cardiovascular Research Centre, Monash University, Melbourne, Victoria, Australia

    Marlies E. Alvarenga

  2. ANU Medical School, Australia National University, Canberra, Aust Capital Terr, Australia

    Don Byrne

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer Science+Business Media Singapore

About this entry

Cite this entry

Bartrop, R., Buckley, T., Tofler, G.H. (2016). Bereavement and the Risk of Cardiovascular Disease. In: Alvarenga, M., Byrne, D. (eds) Handbook of Psychocardiology. Springer, Singapore. https://doi.org/10.1007/978-981-287-206-7_18

Download citation

Publish with us

Policies and ethics

Search

Navigation