Effect of Early Bereavement on Heart Rate and Heart Rate Variability

Study Questions:

What is the effect of bereavement on heart rate (HR) and HR variability?


A total of 78 bereaved spouses and parents (55 women and 23 men; ages 34-87 years, mean age 65) were studied with 24-hour Holter monitoring within 2 weeks of bereavement (acute) and at 6 months. Their findings were compared to those from a nonbereaved reference group (52 women and 27 men) ages 33-91 years (mean age 63.6). All participants were in sinus rhythm. The investigators assessed the mean HR, atrial and ventricular arrhythmias, and both time and frequency domain HR variability measures.


Acute bereavement was associated with increased 24-hour HR (mean ± standard error, 75.1 ± 1.1 vs. 70.7 ± 1.0; p = 0.004) and reduced HR variability, as indicated by lower standard deviation of the NN intervals index (median 45.4 vs. 49.9, p = 0.017), total power (7.78 ± 0.10 vs. 8.02 ± 0.09, p = 0.03), very low frequency (7.23 ± 0.09 vs. 7.44, p = 0.046), and low frequency (5.76 ± 0.12 vs. 6.16 ± 0.09, p = 0.01). At 6 months, the bereaved had a significantly lower HR (p = 0.001) and increased standard deviation of the NN intervals index (p = 0.02), square root of the mean square of differences of successive intervals (p = 0.045), number of interval differences of successive NN intervals >50 ms divided by the number of NN intervals (p = 0.039), low-frequency power (p = 0.02), and high frequency (p = 0.002) compared to the initial acute levels.


The authors concluded that increased HR and altered autonomic function might contribute to the increased cardiovascular events in early bereavement.


This study examined the influence of early bereavement on 24-hour HR and autonomic function and suggests that the early weeks of bereavement are associated with a greater HR and reduced HR variability compared to 6 months later, when the heightened cardiovascular disease risk is reduced. Although these findings do not establish causality, they are consistent with evidence for psychosocial triggers of cardiovascular events, and might partially explain the vulnerability to cardiac diseases in early bereavement. Whether these changes in HR and HR variability might be amenable to intervention during bereavement requires further study.

Clinical Topics: Arrhythmias and Clinical EP, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias

Keywords: Grief, Heart Diseases, Spouses, Cardiovascular Diseases, Electrocardiography, Ambulatory, Heart Rate

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