Common Drugs Might Help Prevent Death From a 'Broken Heart'
When someone close to you dies, grief can literally break your heart, but two common medicines may help prevent a heart attack.
"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," said Dr. Geoffrey Tofler, a professor of preventive cardiology at the University of Sydney in Australia.
Tofler led a groundbreaking clinical trial that found the use of two common medicines -- low-dose aspirin and the blood pressure-lowering beta-blocker metoprolol (Lopressor) -- may reduce survivors' risk of a fatal or nonfatal heart attack.
"A medical check-up for the bereaved is helpful. While most people gradually adjust, doctors can consider this treatment combination as an option," Tofler said.
The risk of heart attack and death is highest in the first days of bereavement -- particularly for those who have lost a spouse or child. For a month afterwards, the risk of heart attack is four times higher than usual, and an increased risk persists for up to six months, Tofler said.
"The bereaved should not neglect their health or ignore symptoms that may be heart-related," he said, adding that family and friends should be extra-supportive at this time.
The combo treatment is a new idea that needs more testing to find out who would benefit most from the therapy, Tofler said. Patients had no side effects from the drugs, he added.
"These 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," he said.
For the study, Tofler's team randomly assigned 85 spouses or parents to a combination of low-dose aspirin and beta-blocker, or a placebo, within two weeks of a family member's death.
After six weeks, the researchers monitored participants' heart rate, blood pressure and changes in blood clotting. Those taking the medications experienced fewer spikes in blood pressure and heart rate, the study found. They also had a better blood-clotting profile.
In addition, people who were taking the medications were less anxious and depressed, Tofler said. To his surprise, lower anxiety and blood pressure levels remained even after the drugs were stopped.
"Our finding on the potentially protective benefit of this treatment is a good reminder for doctors to consider the well-being of the bereaved, and for the bereaved to have a health check-up with their doctor," Tofler said.
Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, reviewed the findings.
He noted that earlier studies have indicated that the emotional stress of grief can cause physical changes, including increases in heart rate, blood pressure, as well as in inflammatory and clotting factors.
This study suggests that aspirin and metoprolol may help reduce the adverse physiologic effects of bereavement, Fonarow said.
"However, larger trials will be needed to test whether or not this approach can lower the risk of fatal and nonfatal cardiovascular events in these vulnerable individuals," he added.
The findings were published in the Feb. 10 issue of the American Heart Journal.
Learn more about preventing heart attacks from the American Heart Association.
SOURCES: Geoffrey Tofler, M.D., professor of medicine, University of Sydney, New South Wales, Australia, and senior staff cardiologist, Royal North Shore Hospital, St. Leonards, Australia; Gregg Fonarow, M.D., professor of cardiology, University of California, Los Angeles, interim director, UCLA Division of Cardiology, and director, Ahmanson-UCLA Cardiomyopathy Center; Feb. 10, 2020, American Heart Journal
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