New research has found that a combination of low-dose aspirin and beta-blockers reduces blood pressure and improves anxiety symptoms during bereavement. The results could result in preventive measures integrated into their practices by clinicians.
Dr Geoffrey Tofler, a professor of preventive cardiology at the University of Sydney’s Faculty of Medicine and Health, Australia, is the lead author of the new study.
He describes the impetus for the study, saying the risk of mortality and adverse cardiovascular events during bereavement is known to increase.
Specifically: “The increased risk[ during bereavement] of heart attack can last up to 6 months. It is the greatest in the first days of bereavement, and continues at four times the amount from 7 days to 1 month after the loss,” states the lead author.
In reality, the authors note in their paper — which appears in the American Heart Journal — that the risk of death following a loved one’s loss accounts for nearly half of an excess mortality during a spouse’s bereavement.
Although the causes of cardiovascular risk remain somewhat uncertain during bereavement, researchers believe that contributing factors may include higher systolic blood pressure and heart rate, lower variability in heart rate, immune changes and anxiety, depression, and rage.
Some previous studies have suggested that beta-blockers, aspirin, or both can alter physiological pathways that get activated in bereavement, Dr. Tofler and the team noted.
The researchers therefore set out to check whether a low dose of beta-blocker metoprolol combined with aspirin could lower cardiovascular risk markers without interfering with the grieving process.
Studying the effects of both drugs
To this end, Dr. Tofler and colleagues recruited 85 participants who in the last 2 weeks had lost either their spouse or a child.
Of those participants, 42 took metoprolol and aspirin in small daily doses for 6 weeks and the others took placebo.
The researchers have asked participants to check their blood pressure at home, taking into account the study’s systolic measurements.
The team also measured the participants ‘ 24-hour average heart rate, anxiety and depression symptoms, and their response to blood clotting — measured by blood platelet reaction to arachidonic acide.
In addition, the group used the Core Bereavement Objects questionnaire to determine the severity of each participant’s bereavement.
Benefits persist after treatment stops
“The main finding was that the active drug, used once a day in a low dose, effectively reduced blood pressure and heart rate increases, as well as showing a substantial change in blood clotting propensity,” Dr. Tofler reports.
He adds, “We were told that the drug had no adverse effect on the psychological responses and indeed lessened the symptoms of anxiety and depression.”
However, “Encouragingly, and to our surprise,” continues the lead researcher, “reduced levels of anxiety and continued blood pressure even after stopping the 6 weeks of daily beta-blocker and aspirin.”
“Our research is the first clinical trial to investigate how early bereavement could reduce the cardiac risk factors,” the professor continues.
Improving the health of bereaved people
Co-author and associate professor Tom Buckley, Ph.D., says, “Our finding on the potentially protective effect of this treatment is also a good reminder for physicians to consider the well-being of the bereaved.”
“Future studies are needed to determine whether these medicinal products can be used for other short periods of severe emotional stress, such as after natural disasters or mass deprivation, where curricular stress can occur.
The findings are also reported on by the co-investigator Holly Prigerson, Ph.D., co-director of the End-of-Life Care Research Center at Weill Cornell Medicine, New York. She said, “This is an important study because it reveals ways to improve the physical and mental health of people with at-risk deprivations.”
“It is a preventive intervention that is potentially practice-changing, using inexpensive, commonly available medicines.”
– Holly Prigerson, Ph.D.
Ultimately, the authors caution that people should not take any of the medications tested in this trial without first discussing their symptoms with a physician, as it can be risky to use them incorrectly.
