title: Haemodynamic changes during early bereavement: potential contribution to increased cardiovascular risk.
abstract: BACKGROUND
  bereavement is associated with increased cardiovascular risk, particularly in surviving spouses and parents, however the mechanism is not well understood due to limited studies. The purpose of this study was to evaluate haemodynamic changes (blood pressure (BP) and heart rate (HR)), that may contribute to increased cardiac risk in early bereavement.
  
  
  METHODS
  we enrolled 80 bereaved individuals and 80 non-bereaved as a reference group. Twenty-four hour ambulatory blood pressure monitoring was performed within two weeks (acute assessment) and at six months following bereavement.
  
  
  RESULTS
  compared to the non-bereaved, the acutely bereaved had higher 24-hour systolic BP (mean (SE) 130.3 (1.5) vs 127.5 (1.4)mmHg, p=0.03), higher daytime systolic BP (135.6 (1.5) vs 131.6 (1.4)mmHg, p=0.02) and higher daytime systolic load (median % 39.0 vs 29.3, p=0.02). By six months the BP of the bereaved tended to be lower than acute measures. This difference was significant amongst those not taking BP lowering medications for 24-hour systolic BP (126.5 (2.4) vs 129.7 (2.3)mmHg, p=0.04), daytime systolic BP (129.8 (2.1) vs 133.9 (2.0)mmHg, p=0.01) and daytime diastolic pressure (76.7 (1.0) vs 78.9 (0.9)mmHg, p=0.03). Twenty-four hour heart rate was also higher acutely in the bereaved compared with the reference group (74.0 (1.2) vs 71.7 (0.9) b/min, p=0.02); at six months heart rate in the bereaved had fallen to non-bereaved levels (70.4 (0.09), p=0.02).
  
  
  CONCLUSIONS
  early bereavement is associated with increased systolic blood pressure and heart rate. These haemodynamic changes may contribute to a time-limited increase in cardiovascular risk.
authors.affiliation: Sydney Nursing School, University of Sydney, Australia.
authors.forename: Thomas
authors.initials: T
authors.lastname: Buckley
authors.forename: Anastasia Susie
authors.initials: AS
authors.lastname: Mihailidou
authors.forename: Roger
authors.initials: R
authors.lastname: Bartrop
authors.forename: Sharon
authors.initials: S
authors.lastname: McKinley
authors.forename: Christopher
authors.initials: C
authors.lastname: Ward
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Morel-Kopp
authors.forename: Monica
authors.initials: M
authors.lastname: Spinaze
authors.forename: Geoffrey H
authors.initials: GH
authors.lastname: Tofler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001601:Bereavement; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors