How you can die of a broken heart

The study, which is the first to investigate this and to compare it with people whose spouse died or survived from something other than a heart attack, also found that men were more susceptible to depression and suicide after their wife's survival or death from an acute myocardial infarction (AMI), than women.

Using Danish registries, including the National Civil Status Registry that shows whether people are married or not, researchers in the USA and Denmark compared 16,506 spouses of people who died from an AMI between 1997 and 2008 with 49,518 spouses of people who died from causes unrelated to AMI.

They also matched 44,566 spouses of patients who suffered a non-fatal AMI with 131,563 spouses of people admitted to hospital for a non-fatal condition unrelated to AMI.

They looked at the use of antidepressants and benzodiazepines (used for treating anxiety) before and up to a year after the event, records of contact with the health system for depression, and suicide.

"We found that more than three times the number of people whose spouses died from an AMI were using antidepressants in the year after the event compared with the year before. In addition, nearly 50 times as many spouses used a benzodiazepine after the event compared to before," Dr Emil Fosbol, first author of the study who is now a cardiologist in Copenhagen, said.

"For people whose spouse had died from a non-AMI cause, we saw a much higher rate of medication use than for other causes and they had an approximately 50 percent higher likelihood of claiming a prescription for these drugs.

"Those whose spouse survived an AMI had a 17 percent higher use of antidepressants after the event, whereas spouses of patients surviving some other, non-AMI related condition had an unchanged use of antidepressants after the event compared to before.

"Overall, the rates of depression were significantly higher after the event in the fatal AMI group and in the fatal non-AMI group. Although the rates were low, those who had lost a spouse to a fatal AMI or whose spouse survived an AMI more often committed suicide than those with spouses who died from, or survived, a non-AMI-related event. We also found that men were more likely to suffer depression and commit suicide after an event than women," Fosbol said.

The researchers speculate that it is the sudden and unexpected nature of an AMI that causes a more extreme impact on the spouse.

"If your partner dies suddenly from a heart attack, you have no time to prepare psychologically for the death, whereas if someone is ill with, for example, cancer, there is more time to grow used to the idea," Dr Fosbol said.

"The larger psychological impact of a sudden loss is similar to post-traumatic stress disorder," Fosbol added.

The study has been recently published online in the European Heart Journal.
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