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Broken Hearted: Cardiovascular Effects of Grief

Posted by Manuela Boyle on 3 March 2022
Broken Hearted: Cardiovascular Effects of Grief

The loss of a child may be the most significant grief any person can experience in life. It comes as no surprise that bereaved parents experience a decline in physical and mental health.They utilize healthcare services more, call in sick more often, miss more work, and report more sleep problems than non-bereaved parents. There is no doubt that grief is a major stress; it is hard on people and hard on their health.

Past research has demonstrated an association between grief and dying of cardiovascular disease. Loss of a spouse may be the best-studied bereavement, and it is well-established that spousal bereavement leads to a period of heightened cardiovascular risk for the surviving spouse. Colin Murray Parkes, OBE, MD, FRCPsych, DL, reported this association in widowers as early as 1969. Since then, the association has been seen in multiple studies. The immediate weeks after bereavement represent the highest risk period for both men and women across all ages. The increased risk occurs whether the spouse’s death is expected or unexpected. While high levels of social support offer some degree of protection, losing a spouse increases risk of death in the survivor from almost any cause, in particular cancer, infection, and cardiovascular disease.

In a 2007 study by Hart et al that followed 4,395 married couples (aged 45–64 years), after the death of a spouse, bereaved participants were at higher risk of dying from any cause (RR 1.27; 95% CI 1.2–1.35). Relative risk of death increased for cardiovascular disease, coronary heart disease, stroke, all cancers, lung cancer, smoking-related cancer, and accidents or violence. After adjustment for confounding variables, RRs remained higher for bereaved participants from all these causes, except from lung cancer. There was no strong statistical evidence in this particular study that the increased risks of death associated with bereavement changed with time after bereavement.

More often though, the studies have suggested that risk is higher immediately after bereavement and then lessens over time. Carey et al, in a UK study from 2014, followed 30,447 people who had lost a partner and who were matched with similar but unbereaved controls; they reported that “Within 30 days of their partner’s death, 50 of the bereaved group (0.16%) experienced an MI or a stroke” compared with 67 of the controls (0.08%) during the same period (IRR, 2.20). Risk of MI more than doubled (IRR, 2.14) and risk of stroke increased nearly 2.5 times that of the control group (IRR, 2.40). Bereaved women were at greater risk than men during the first 30 days (IRR, 2.93 vs. 1.65) but the risk equalised between sexes during the first year of bereavement.

The impact of the death of other significant people on mortality has only recently been the subject of scientific scrutiny.

A 2002 study by Liong Ji et al may be the earliest report of an association between the death of a child and increased risk of MI (N=19,361). Risk of a fatal MI increased by 36% for bereaved parents. These same authors went on to report in 2003 that among the same cohort of bereaved parents, there was no increase in risk of stroke or, in a 2004 report, that there was no increased risk of inflammatory bowel disease (IBD).

The death of anyone dear increases risk of a MI. In 2013, Mikael Rostila reported that even the death of an adult sibling was associated with increased risk of death from MI, particularly among women (HR, 1.25 for women vs 1.15 for men). If that sibling died from MI, the associations were stronger, HR for women 1.62 and men.

Yet, from these scattered data, it is not clear whether the relative risk of death changes with the intensity of the emotion experienced. Researchers have ranked the experiences of grief by intensity from the more to less intense and reported that the grief of bereaved parents > bereaved spouses > bereaved adult children.

The assumption is that “The grief experienced by parents is more intense and prolonged than grief experienced following the death of other family members.” Children are expected to outlive their parents; the disruption in this natural order can destroy parents’ hopes and dreams for the future. A child’s death may also profoundly change parents’ roles and sense of self as responsibilities of caring for their now-deceased child are removed.

The intensity of parental grief is thought to be due to the close and enduring relationships parents assume that they would have with their children. Although one might predict that the ill health caused by bereavement might follow a parallel path, the worse the grief the worse the decline in health, the data so far do not appear to support this idea.

Instead, research is focusing more on the process of grief and how people go through the experience:

Perhaps the most important thing to understand is that caring for bereaved parents is not something to take on alone; it takes a team of people to provide the emotional safety net that these people will need. 

Of course, there are certain interventions that most integrative doctors will think of and consider as adjunctive aids. The homeopathic repertory is rich in remedies listed for “ailments from grief.” Many of these cover the symptoms described in the new diagnostic description of “complicated grief.” A few are also prescribed for cardiac conditions.

In the botanical pharmacopeia, we often think of extracts of Hawthorne berry (genus Crataegus) as both supportive of cardiac function and healing of emotional injury. Another consideration might be the traditional Chinese combination of Hawthorne berry and Polygonum cuspidatum, a formula known as Huzhang-Shanzha, which is commonly prescribed for congestive heart failure.




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Author:Manuela Boyle
Tags:NewsEvidence Based ResearchCancerHerbal MedicineGrief and Loss


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