Abstract
Myocardial infarction and sudden cardiac death are well recognised as being associated with emotional stress. Emotional upset, 1 Tofler G.H. Stone P.H. Maclure M. Edelman E. Davis V.G. Robertson T. et al. Analysis of possible triggers of acute myocardial infarction (the MILIS study). Am J Cardiol. 1990; 66: 22-27 Abstract Full Text PDF PubMed Scopus (309) Google Scholar anger 2 Mittleman M.A. Maclure M. Sherwood J.B. Kondo N.I. Tofler G.H. Muller J.E. et al. Triggering of acute myocardial infarction onset by episodes of anger. Determinants of Myocardial Infarction Onset Study Investigators. Circulation. 1995; 92: 1720-1725 Crossref PubMed Scopus (617) Google Scholar , 3 Moller J. Hallqvist J. Diderichsen F. Theorell T. Reuterwall C. Ahlbom A. Do episodes of anger trigger myocardial infarction? A case-crossover analysis in the Stockholm Heart Epidemiology Program (SHEEP). Psychosom Med. 1999; 61: 842-849 PubMed Google Scholar , 4 Koton S. Tanne D. Bornstein N.M. Green M.S. Triggering risk factors for ischemic stroke: a case-crossover study. Neurology. 2004; 63: 2006-2010 Crossref PubMed Scopus (73) Google Scholar and anxiety 2 Mittleman M.A. Maclure M. Sherwood J.B. Kondo N.I. Tofler G.H. Muller J.E. et al. Triggering of acute myocardial infarction onset by episodes of anger. Determinants of Myocardial Infarction Onset Study Investigators. Circulation. 1995; 92: 1720-1725 Crossref PubMed Scopus (617) Google Scholar have all been associated with an increase in cardiovascular risk. It is widely acknowledged that bereavement contributes significantly to emotional stress and requires significant psychosocial adjustment 5 Stroebe M. Schut H. Stroebe W. Health outcomes of bereavement. Lancet. 2007; 370: 1960-1973 Abstract Full Text Full Text PDF PubMed Scopus (1086) Google Scholar , 6 Stroebe M.S. Handbook of bereavement research: consequences, coping, and care. American Psychological Association, Washington, DC2001 Crossref Google Scholar , 7 Maciejewski P.K. Zhang B. Block S.D. Prigerson H.G. An empirical examination of the stage theory of grief. JAMA. 2007; 297: 716-723 Crossref PubMed Scopus (374) Google Scholar and an increase in morbidity and mortality has been noted in those who have lost a parent or spouse. 8 Goodenough B. Drew D. Higgins S. Trethewie S. Bereavement outcomes for parents who lose a child to cancer: are place of death and sex of parent associated with differences in psychological functioning?. Psychooncology. 2004; 13: 779-791 Crossref PubMed Scopus (85) Google Scholar , 9 Jagger C. Sutton C.J. Death after marital bereavement—is the risk increased?. Stat Med. 1991; 10: 395-404 Crossref PubMed Scopus (73) Google Scholar , 10 Schaefer C. Quesenberry Jr., C.P. Wi S. Mortality following conjugal bereavement and the effects of a shared environment. Am J Epidemiol. 1995; 141 ([see comment]): 1142-1152 PubMed Google Scholar , 11 Martikainen P. Valkonen T. Mortality after death of spouse in relation to duration of bereavement in Finland. J Epidemiol Community Health. 1996; 50: 264-268 Crossref PubMed Scopus (121) Google Scholar While this increased risk is recognised, the mechanism by which it occurs is not well understood.
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