The Brain-Heart Connection: How Inhibition Relates to Cardiovascular Disease

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Project Summary/Abstract The loss of a spouse is rated as the most stressful experience one can encounter. In the face of a loss, people are physiologically and emotionally dysregulated. As a result, bereaved individuals are at increased risk of mortality. Indeed, within six months after the death of a spouse, mortality rates range from 40-100%, with cardiovascular disease (CVD) accounting for 20-53% of these deaths. However, not all individuals experience physical and emotional difficulties after a loss. A better understanding of the mechanisms associated with adjustment following a loss is important for informing interventions aimed at reducing health disparities. People experiencing increased stress, such as those faced with a loss, exhibit heightened inflammatory responses in comparison to those who are less stressed. Importantly, inflammation is a predictor of all stages of CVD from initial lesion to end-stage thrombotic complications. Therefore, as bereaved individuals are at increased risk of being stressed, inflammation may be a key mechanism underlying CVD following a loss. Bereaved individuals are also at increased risk of reporting symptoms of depression and low health-related quality of life (HRQOL). Depression and HRQOL are interrelated, and both are reliable risk factors for CVD. Rumination may be a key contributor to inflammation, depression, and HRQOL among the bereaved. Rumination is defined as repeatedly focusing one’s attention on distressing thoughts, and has been found to be associated with poor adjustment following a loss. Importantly, some people have difficulty stopping themselves from ruminating, even when actively attempting to do so. The cognitive skill of inhibition differentiates individuals who are able to stop themselves from ruminating from those who are not. Inhibition is defined as the ability to restrain oneself from engaging in natural instincts such as ruminating. Those with poor inhibition have been found to be at risk for heightened inflammation and depression, as well as poor HRQOL. Importantly, inhibition is a modifiable skill and improvements in inhibition are associated with decreased rumination. As a result, examination of inhibition as it relates to inflammation, depression, and HRQOL following a loss may further our understanding of CVD risk among the bereaved. This project builds upon preliminary findings to longitudinally examine inhibition as it relates to inflammation, depression, and HRQOL among the bereaved. Participants will be spouses of individuals who recently passed away. Indicators of inhibition, inflammation, depression, and HRQOL will be collected at 2 months, 4 months, 6 months, and 12 months after the spouse’s death. If inhibition is associated with the hypothesized mechanisms underlying CVD risk, then stressed individuals may benefit from exposure to interventions targeting improved inhibition. Such interventions may be especially important to implement among those with low inhibition that are faced with stressful experiences such as a loss.