In the first days after a relative dies, do not stay alone; if you have heart disease, hypertension, or diabetes, keep taking the medicine; if the chest feels pressed and hurts, call 120

On the day after a relative dies, the chance of a heart attack is 21.1 times the usual chance, and each day after that it is lower. Among people aged 60 to 89, the share who have a heart attack or a stroke within 30 days after a spouse dies is about double, and it falls back after a month. If you already have cardiovascular disease, do not stop the medicine these days. If the chest feels pressed and hurts, you cannot catch your breath, or an arm or a leg on a single side has no strength, call 120 at once.

Cost

No money. Do not stay alone these days, and keep taking the medicine.

Benefit

1985 patients with an acute heart attack, comparing different stretches of time in the same person, before and after the attack. Of them, 270 (13.6%) had lost an important person in the 6 months before the attack, and 19 had lost that person within 1 day before the heart attack. Within 24 hours after an important person died, the rate of acute heart attack was 21.1 times higher (95% CI 13.1–34.1, and the true multiple sits roughly between 13 and 34). After that it fell day by day. In actual counts: among people with a decade-long heart-attack risk of 5%, each 1394 people who had just lost a relative produced 1 extra case. Among people with a risk of 20%, each 320 people produced 1 extra case. Another study in Britain compared 30447 widowed people aged 60 to 89 with 83588 controls in similar circumstances. Within 30 days after the death of the spouse, a heart attack or a stroke occurred in 50 people on the widowed side (0.16%) and in 67 people on the control side (0.08%). The IRR was 2.20 (1.52–3.15), that is, the chance of the event was about 2.2 times the control group. Of that, heart attack was 2.14 (1.20–3.81), about 2.1 times. Stroke was 2.40 (1.22–4.71), about 2.4 times. After 30 days it weakened. Within 90 days they also looked at further illnesses. The first was acute coronary syndrome that was not a heart attack (an acute problem with the blood supply to the heart that still falls short of a heart attack), IRR 2.20 (1.12–4.29). The other was pulmonary embolism (a clot blocking a blood vessel in the lung), IRR 2.37 (1.18–4.75). The British National Health Service (NHS) lists the signs for which you should call the emergency number at once. A heart attack is pain in the chest as if it were being pressed or squeezed. The pain can spread to the arm, the neck, or the jaw, and there is also shortness of breath. A stroke is a side of the face drooping, an arm or a side of the body weak or numb, and slurred speech.

Notes

Hand the medicine box to someone else to manage. Do not rely on remembering it yourself. Do not take a long trip these days. Do not get through it on alcohol. The account of alcohol is in section 2. How to recognize a heart attack or a stroke, and how to call for a car, is in section 13. Both studies looked back through population records. They cannot separate out how many of these people were going to fall ill anyway. Both point the same way, and both point at the same stretch of time. If there is nobody you can hand the medicine box to, and these days you are bound to be alone in the room, see item 6 of this section.

Sources · 4

1. Mostofsky E, et al. (2012). Risk of acute myocardial infarction after the death of a significant person in one's life: the Determinants of Myocardial Infarction Onset Study. Circulation. doi.org/10.1161/CIRCULATIONAHA.111.061770
2. Carey IM, et al. (2014). Increased risk of acute cardiovascular events after partner bereavement: a matched cohort study. JAMA Internal Medicine. doi.org/10.1001/jamainternmed.2013.14558
3. NHS. Heart attack: symptoms. nhs.uk/conditions/heart-attack/symptoms/
4. NHS. Symptoms of a stroke. nhs.uk/conditions/stroke/symptoms/