Medicines

Beta blocker and aspirin suggested for bereavement CVD risk prophylaxis


Prof Geoffrey Tofler

Professor Geoffrey Tofler

A short period of treatment with low dose metoprolol and aspirin in people who are recently bereaved appears to reduce their cardiovascular risk.

The findings, from an Australian study, are consistent with other evidence that the drugs can provide protection against emotional and stress-related triggers of CVD.

The small study randomised 85 spouses, partners or parents of patients who had died in one of five hospitals in Northern Sydney.

Enrolment was typically within 12 days of their bereavement and patients received six weeks of either the intervention medications or placebo.

At the end of the treatment period, the intervention group had lower home systolic blood pressure, morning systolic pressure, average 24-hour heart rate, minimum and maximum heart rates, and platelet response to arachidonic acid than controls.

The intervention group also had lower levels of anxiety and depression symptoms however there were no significant differences in bereavement intensity or anger.

Heart rate variability, platelet granulocyte aggregates and von Willebrand factor were also not altered by the intervention.

“The finding that low dose metoprolol and aspirin has a positive impact on several surrogate cardiovascular risk markers including anxiety, and is well tolerated in early bereavement with no negative impact on bereavement intensity up to 6 months, enables clinicians to consider this treatment in their patients,” the study said.

“While clinicians need to be wary of appearing to medicalise an almost universal stressful experience, reducing heart attacks among bereaved people is a worthy goal.”

The authors, led by Professor Geoffrey Tofler of the Royal North Shore Hospital and University of Sydney, said the findings suggested the beta blocker/aspirin combination may also be applicable in other acute stress situations.

“While the present study focused on bereavement due to the death of partners and children, our findings are relevant to other causes of bereavement, including job loss, relationship breakdown, trauma and deaths of other loved ones, including pets.”

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