Does the death of the partner have an influence on the risk of atrial fibrillation?

iStock_000024649569XSmallStress can be caused by many diseases. This correlation has already been proved in acute diseases of the cardiovascular system such as myocardial infarction. The loss of the partner is considered to be one of the most stressful life experiences. Bereavement may be the cause of mental illness for example depression. Can the stress of bereavement cause of other diseases?

The scientists from Denmark have verified the correlation between the stress caused by the death of a partner and the risk of atrial fibrillation. In the years 1995-2014 they study Danish population including 5.6 million inhabitants. The data of patients with a first-time diagnosis of AF included health, information on residence, level of education, marital status, cohabitant status, date of death and partner’s data were collected using Danish National Patient Register.

The control groups were selected among the citizens living in Denmark without atrial fibrillation in the history at inclusion in the study. The control groups were selected to each case, they included ten people of the same sex and the same age with a maximum difference of two months.

Marital status and loss of the partner in a short period of time before first-time diagnosis were checked in all patients using the Danish Civil Registration System. Using the Age-adjusted Charlson Comorbidity Index (ACCI) the scientists estimated the probability of death for all partners in the month before their death.

Risk of AF was calculated depending on the duration of bereavement and health partner one month before his death. The study also included sex, age, and previously diagnosed diseases such as hypertension, ischaemic heart disease, diabetes and other conditions that may increase the risk of atrial fibrillation. The study excluded people who redeemed a prescription of an antithrombotic agent before the diagnosis of AF.

In the years 1995-2004, atrial fibrillation was diagnosed in 88 612 people, and 886 120 citizens were the control group. During the research 19.72% of patients and 19.07% of the control group lost a partner. There are 144 cases and 1036 controls were bereaved in 30 days before atrial fibrillation.

Bereavement temporarily increased the risk of atrial fibrillation, it was the highest 8-14 days after the death of a partner and then gradually decreased. A year after the lost risk was similar to risk in the population.

In conclusion, high level of stress caused by death of a partner can increase the risk of new cases of atrial fibrillation. The risk is higher for one year and therefore early identification of people in bereavement and increased frequency of testing at this time would be legtimate.

Written by: Dominika Guz

1. Graff S., Fenger-Grøn M., Christensen B., Søndergaard Pedersen H., Christensen J., Li J., Vestergaard M. Long-term risk of atrial fibrillation after the death of a partner; Open Heart 2016;3: doi:10.1136/openhrt-2015-000367.
2. Carey IM, Shah SM, DeWilde S et al. Increased risk of acute cardiovascular events after partner bereavement: a matched cohort study. JAMA Intern Med 2014;174:598–605.
3. Holmes TH, Rahe RH. The social readjustment rating scale. J Psychosom Res 1967;11:213–18.

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