Cardiovascular risk in early bereavement: a literature review and proposed mechanisms.
OBJECTIVE
The purpose of this review was to examine the evidence of cardiovascular risk in early bereavement to identify potential risk factors and possible mechanisms for risk that may inform future research directions.


METHODS
A comprehensive search of electronic databases PubMed Medline, CINAHL and PsycINFO, bereavement related textbooks and reviewed reference lists was undertaken on literature related to evidence of increased risk in bereavement. No limits were set on the searches in terms of date or publication type, but only English language articles were selected.


RESULTS
Bereavement represents a time of heightened cardiovascular risk for the surviving spouse. The immediate weeks following bereavement represent the highest risk period with both men and women across all ages. Risk is evident irrespective of the nature of death, expected or unexpected, although higher level of social support at the time of death may be protective. Evidence would suggest that for many, bereavement results in a time of increased psychological stress and potential for altered behavioural health risk factors that in the presence of altered physiological state, may serve as a potential trigger of cardiovascular events, especially in those most at risk.


CONCLUSIONS
The findings from this review provide insight into the impact of early bereavement on health and the recognition that bereavement is associated with increased cardiac risk. This recognition should provide an impetus for individuals to act on cardiac symptoms by seeking medical advice and for health care providers to monitor such individuals more closely.
Buckley
Thomas
T
The University of Sydney, Sydney, NSW 2006,Australia. tabuckley@hotmail.com
McKinley
Sharon
S
Tofler
Geoffrey
G
Bartrop
Roger
R
D000368:Aged; D000786:Anger; D001007:Anxiety; D001601:Bereavement; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D003863:Depression; D005260:Female; D006339:Heart Rate; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D012307:Risk Factors; D012944:Social Support; D018454:Spouses
D006854:Hydrocortisone