Study published on Wednesday journal JACC: Heart failure, Patients in mourning, especially in the first week after the death of their family, were found to be at increased risk of death.
Researchers, including researchers at the Karolinska Institute in Sweden, say that mourning the loss of relatives can increase stress levels, which contributes to a poor prognosis for heart failure (HF).
Previous studies have demonstrated that depression, anxiety, and poor social support are associated with a poor prognosis in HF patients, and many previous studies have shown severe psychological stress and broken heart syndrome. It has also been confirmed to be related to (also called “takotsubo cardiomyopathy”).
In a new study, scientists found approximately 500,000 patients from the Swedish heart failure registry between 2000 and 2018, and / or patients who received a primary diagnosis of HF from the Swedish patient registry between 1987 and 2018. I checked.
Researchers also obtained data on the dates and causes of family deaths from the cause of death registry.
Evaluation of the data revealed that 58,949 study participants experienced mourning during an average of 3.7 years of follow-up.
The study also evaluated whether the relationship with death, cause of death, or time elapsed after death affected HF mortality risk.
Researchers found that the association between bereavement after death of a child (10% increased risk), spouse / partner (20% increased risk), grandchildren (5% increased risk), or siblings and increased HF mortality risk Was found (risk increased by 13%), but not after the death of the parent.
They state that the risk of dying from HF after losing a family was highest in the first week of bereavement, with a 78% increase in risk.
Studies have found that this is especially true in the case of the death of a child or partner.
Also, in contrast to one loss (28% risk increase), two losses (35% risk increase) were higher.
“Our findings that bereavement is associated with mortality in HF patients contributes to and extends existing literature on the role of stress in the prognosis of HF, increasing the risk of bereavement and developing cardiovascular disease. This is consistent with studies reporting an association with research co-author Hua Chen.
Researchers believe that bereavement activates the hypothalamic-pituitary-adrenal (HPA) axis. It is an important neuroendocrine system that regulates stress and emotional responses.
They also say that they can provoke a response between the renin-angiotensin-aldosterone system (RAAS) and the sympathetic nervous system, which are the main features of the HF neuroendocrine response.
“The results of this study may require increased attention from family, friends, and related professionals to bereaved heart failure patients, especially in the immediate post-loss period,” said another author of the study. Christina Laszlo said.
Scientists cite some of the limitations of the study and say that the confounding effects of family-shared genetic factors and unmeasured socio-economic, lifestyle, and health-related factors cannot be ruled out. I did.
Researchers say the findings may only be generalized to countries with similar social and cultural backgrounds and health-related factors as Sweden.
In future studies, they hope to assess whether less serious sources of stress can contribute to a poor prognosis for HF.
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