Losing someone you love doesn't just cause profound emotional effects. Physical changes are also triggered during the first weeks of bereavement.
A world-first study funded by the North Shore Heart Research Foundation has found that these symptoms increase the risk of heart attack – and even occur in people in their 30s.
Psychological factors such as depression are known to play an important role in heart disease, as well as the major risk factors such as smoking, high blood pressure, diabetes and high cholesterol.
But until now the links between bereavement and heart health have not been well understood.
The CARBER study
The study is known as CARBER (Cardiovascular Effects of Bereavement). It is the first study to look in detail at people during the first weeks of losing a spouse or family member.
The lead researcher is Dr Thomas Buckley, Senior Lecturer from the Faculty of Nursing and Midwifery at the University of Sydney. Professor Geoffrey Tofler, Cardiologist at Royal North Shore Hospital, is the senior study investigator.
The results of the first phase (CARBER I) provided clues for preventive measures, which the team plans to investigate.
Volunteer participants
Eighty bereaved men and women, aged 33 to 84 years, were enrolled from Royal North Shore Hospital, Ryde, Hornsby, Mona Vale and Manly Hospitals. They were measured against a control group.
The assessment included an ECG, 24-hour blood pressure and monitoring, blood tests and other biochemical changes. Psychological effects were also monitored.
The participants responded positively, largely because of the efforts of the multidisciplinary research team. Included were specialists in social work, critical care and research nursing, psychology, psychiatry, haematology and cardiology.
Findings: increased risk of heart attack
All participants showed emotional and physical symptoms that could contribute to a heart attack. These included increased anxiety, depression and anger, raised blood pressure and stress hormones, reduced sleep and appetite, and changes in blood-clotting and immunity.
Professor Tofler said the findings show the importance of maintaining the health of bereaved family members.
The next phase: preventing bereavement-related heart attacks
A second study (CARBER II) is now underway. Researchers will test whether it is possible to reduce the risk of heart disease during the early weeks of bereavement. The aim is to develop preventive strategies for this high-risk time.
Understanding the body's response could point to measures such as the use of beta-blocker drugs or aspirin to protect against changes in adrenaline levels and blood-clotting. This could ultimately reduce the risk of heart attacks in the bereaved.
Read full report of CARBER I in the Journal of Internal Medicine 
The CARBER research team
(Standing, from left) Sharon McKinley, Geoffrey Tofler, Marie-Christie Morel-Kopp, Walther Chen, Angela Stannard, Anastasia Susie Mihailidou, Margaret Bramwell, Dianne Roche
(Seated, from left) Monica Spinaze, Christopher Ward, Thomas Buckley, Roger Bartrop, Jennifer Havyatt
See also
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