Risk of stroke after bereavement-a systematic literature review

Abstract

Several studies have suggested that psychological stress may increase the risk of stroke. However, this link remains a controversial issue because of conflicting findings. Bereavement, the loss of a close relative, is considered a severely stressful life event. Increased risk of stroke could thus be expected after bereavement if stress plays a causal role. We aimed to evaluate the association between bereavement and stroke by performing a systematic review of the existing literature. The literature search was conducted according to the PRISMA guidelines for systematic reviews. A search in Medline and Embase identified eligible studies, which were reviewed by two researchers independently according to specific inclusion criteria. We included six studies: five cohort studies and one case-crossover study. Five studies found that loss of a first-degree relative was associated with a 1.1- to 2.4-fold higher risk of stroke. However, one study found a statistically significant overall risk only for women. Five studies evaluated the risk of stroke according to time since the loss; one study found no association, two studies indicated short-term effect, one study indicated long-term effect, and one study indicated both short-term and long-term effect. Three studies stratified their analysis by sex; two found higher association in bereaved women than men. Our systematic review suggests that bereavement-related stress is associated with a higher risk of stroke. As relatively few studies were identified, new studies are needed to verify this association. These should aim to quantify the risk, describe the effect of time since bereavement, and identify risk-modifying factors.

Death of a child and the risk of heart failure: a population-based cohort study from Denmark and Sweden

“…Our findings are in line with several earlier studies showing a 9%-140% increased risk of stroke in persons exposed to the death of a spouse, sibling, or an unspecified relative. 6 Similarly, our results are also comparable to associations reported between other psychosocial factors such as work stress, anxiety, and depression and the risk of stroke. [10][11][12][13][14][15] Our findings corroborate studies 1-5 that showed increased risks of acute myocardial infarction, atrial fibrillation, heart failure, and death due to CVD among bereaved parents.…”

“…A recent systematic review suggests that the death of a close family member is associated with an increased risk of stroke; however, the majority of the 6 studies included in the review focused on spousal bereavement. 6 To our knowledge, only one study has so far investigated the link between the death of a child aged <18 years and stroke; its finding of no association might be due to the fact that parents were too young to experience stroke at the end of the follow-up. 7 In this population-based cohort study with a long follow-up period (up to 39 years), we investigated whether parents who lost an offspring had an increased risk of stroke, and if so, whether the risk differed by characteristics of the child's death, time since death, and sociodemographic factors of the family or according to subtypes of stroke.…”

The Psychobiology of Bereavement and Health: A Conceptual Review From the Perspective of Social Signal Transduction Theory of Depression

“…Losing a spouse can be a very stressful life event that places individuals at risk for mental and physical health problems (1,2). Particularly in the immediate weeks and months following spousal loss, bereavement is associated with increased risk of multimorbidity and mortality (2-5), including an elevation in inflammation-related health problems (6-10), cardiovascular disease (CVD) (8, [11][12][13][14], and some types of cancer (12). Despite a large body of research in the trauma literature attempting to identify risk factors for adverse health outcomes following spousal bereavement, however, the mechanisms through which mental and physical health problems emerge following interpersonal loss remain poorly understood.…”

Circulating endocannabinoid concentrations in grieving adults

“…Such an attachment loss typically leads to acute grief symptoms that include yearning and longing for the loved one; intrusive thoughts and avoidance of reminders of the deceased; sadness and other painful emotions; loneliness, shock and disbelief; and emotional numbness (Shear, 2012;Shear et al, 2013;Simon, 2013). Bereavement among the elderly is associated with precipitating or worsening of mental disorders; decrements in physical health; and increased risk of hospitalization; cardiovascular risk; and premature mortality (Aalbaek et al, 2017;Ennis and Majid, 2019;Stroebe et al, 2007). Most individuals successfully adapt to the emotional consequences of bereavement without seeking mental health care.…”