Haemodynamic Changes During Early Bereavement: Potential Contribution to Increased Cardiovascular Risk
Haemodynamic Changes During Early Bereavement: Potential Contribution to Increased Cardiovascular Risk
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DOI：
10.1016/j.hlc.2010.10.073
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发表时间：
2011-02-01
影响因子：
2.6
通讯作者：
Tofler, Geoffrey H.
中科院分区：
文献类型：
--
作者：
Buckley, Thomas;Mihailidou, Anastasia Susie;Tofler, Geoffrey H.
背景：丧亲与心血管风险增加有关，特别是在尚存的配偶和父母中，然而，由于研究有限，其机制尚不清楚。这项研究的目的是评估血液动力学变化(血压和心率)，可能导致早期丧亲的心脏风险增加。方法：我们招募了80名丧亲者和80名非丧亲者作为参照组。结果：与非丧亲者相比，急性丧亲者24小时平均收缩压(SE)为130.3(1.5)比127.5(1.4)mm Hg，白天高(135.6)(1.5)比131.6(1.4)mm Hg(P=0.02)；到六个月时，丧亲者的血压往往低于急性指标。在未服用降压药的患者中，24小时收缩压(126.5(2.4)vs 129.7(2.3)mm Hg，p=0.0 4)、日间收缩压(129.8(2.1)vs 133.9(2.0)mm Hg，p=0.0 1)和日间舒张压(76.7(1.0)vs 78.9(0.9)mm Hg，p=0.0 3)差异显著。丧亲者的24小时心率也显著高于对照组(74.0(1.2)比71.7(0.9)b/min，P=0.02)；6个月时，丧亲者的心率已降至非丧亲者水平(70.4(0.09)，P=0.02)。结论：早期丧亲与收缩压和心率增加有关。这些血流动力学变化可能会导致心血管风险的有限增加。(《心、肺和循环》2011；20：91-98)2010澳大利亚心脏和胸科外科医生学会以及澳大利亚和新西兰心脏学会。爱思唯尔公司出版，版权所有。(C)2010年澳大利亚心脏和胸科外科医生学会以及澳大利亚和新西兰心脏学会。爱思唯尔公司出版，版权所有。
Background: Bereavement is associated with increased cardiovascular risk, particularly in surviving spouses and parents, however the mechanism is not well understood due to limited studies. The purpose of this study was to evaluate haemodynamic changes (blood pressure (BP) and heart rate (HR)), that may contribute to increased cardiac risk in early bereavement.Methods: We enrolled 80 bereaved individuals and 80 non-bereaved as a reference group. Twenty-four hour ambulatory blood pressure monitoring was performed within two weeks (acute assessment) and at six months following bereavement.Results: Compared to the non-bereaved, the acutely bereaved had higher 24-hour systolic BP (mean (SE) 130.3 (1.5) vs 127.5 (1.4) mm Hg, p = 0.03), higher daytime systolic BP (135.6 (1.5) vs 131.6 (1.4) mm Hg, p = 0.02) and higher daytime systolic load (median % 39.0 vs 29.3, p = 0.02). By six months the BP of the bereaved tended to be lower than acute measures. This difference was significant amongst those not taking BP lowering medications for 24-hour systolic BP (126.5 (2.4) vs 129.7 (2.3) mm Hg, p = 0.04), daytime systolic BP (129.8 (2.1) vs 133.9 (2.0) mm Hg, p = 0.01) and daytime diastolic pressure (76.7 (1.0) vs 78.9 (0.9) mm Hg, p = 0.03). Twenty-four hour heart rate was also higher acutely in the bereaved compared with the reference group (74.0 (1.2) vs 71.7 (0.9) b/min, p = 0.02); at six months heart rate in the bereaved had fallen to non-bereaved levels (70.4 (0.09), p = 0.02).Conclusion: Early bereavement is associated with increased systolic blood pressure and heart rate. These haemodynamic changes may contribute to a time-limited increase in cardiovascular risk. (Heart, Lung and Circulation 2011;20:91-98) 2010 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier Inc. All rights reserved. (Heart, Lung and Circulation 2011;20:91-98) (C) 2010 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier Inc. All rights reserved.