TY - JOUR
T1 - The effect of metoprolol and aspirin on cardiovascular risk in bereavement
T2 - a randomized controlled trial
AU - Tofler, Geoffrey H.
AU - Morel-Kopp, Marie Christine
AU - Spinaze, Monica
AU - Dent, Jill
AU - Ward, Christopher
AU - McKinley, Sharon
AU - Mihailidou, Anastasia S.
AU - Havyatt, Jennifer
AU - Whitfield, Victoria
AU - Bartrop, Roger
AU - Fethney, Judith
AU - Prigerson, Holly G.
AU - Buckley, Thomas
PY - 2020/2
Y1 - 2020/2
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85077655453&partnerID=8YFLogxK
U2 - 10.1016/j.ahj.2019.11.003
DO - 10.1016/j.ahj.2019.11.003
M3 - Article
C2 - 31923768
AN - SCOPUS:85077655453
SN - 0002-8703
VL - 220
SP - 264
EP - 272
JO - American Heart Journal
JF - American Heart Journal
ER -