The effect of metoprolol and aspirin on cardiovascular risk in bereavement: a randomized controlled trial

Geoffrey H. Tofler*, Marie Christine Morel-Kopp, Monica Spinaze, Jill Dent, Christopher Ward, Sharon McKinley, Anastasia S. Mihailidou, Jennifer Havyatt, Victoria Whitfield, Roger Bartrop, Judith Fethney, Holly G. Prigerson, Thomas Buckley

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    13 Citations (Scopus)


    Background: Bereavement is associated with an increased risk of cardiovascular disease; however, no reports exist of interventions to reduce risk. In a randomized, double-blind, placebo-controlled trial of 85 recently bereaved participants, we determined whether β-blocker (metoprolol 25 mg) and aspirin (100 mg) reduce cardiovascular risk markers and anxiety, without adversely affecting bereavement intensity. Methods: Participants were spouses (n = 73) or parents (n = 12) of deceased from 5 hospitals in Sydney, Australia, 55 females, 30 males, aged 66.1 ± 9.4 years. After assessment within 2 weeks of bereavement, subjects were randomized to 6 weeks of daily treatment or placebo, and the effect evaluated using ANCOVA, adjusted for baseline values (primary analysis). Results: Participants on metoprolol and aspirin had lower levels of home systolic pressure (P =.03), 24-hour average heart rate (P <.001) and anxiety (P =.01) platelet response to arachidonic acid (P <.001) and depression symptoms (P =.046) than placebo with no difference in standard deviation of NN intervals index (SDNNi), von Willebrand Factor antigen, platelet-granulocyte aggregates or bereavement intensity. No significant adverse safety impact was observed. Conclusions: In early bereavement, low dose metoprolol and aspirin for 6 weeks reduces physiological and psychological surrogate measures of cardiovascular risk. Although further research is needed, results suggest a potential preventive benefit of this approach during heightened cardiovascular risk associated with early bereavement.

    Original languageEnglish
    Pages (from-to)264-272
    Number of pages9
    JournalAmerican Heart Journal
    Publication statusPublished - Feb 2020


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