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The effect of metoprolol and aspirin on cardiovascular risk in bereavement: A randomized controlled trial
Geoffrey H Tofler1, Marie-Christine Morel-Kopp2, Monica Spinaze1
1Royal North Shore Hospital, St Leonards, NSW, Autralia; University of Sydney, Sydney, NSW, Autralia.
Insights
Bereavement increases cardiovascular risk. A trial found that low-dose metoprolol and aspirin reduced cardiovascular risk markers and anxiety in recently bereaved individuals without worsening grief.
Area of Science:
- Cardiology
- Psychiatry
- Pharmacology
Background:
- Bereavement is a known risk factor for cardiovascular disease.
- There is a lack of interventions to mitigate this increased risk.
- This study investigated the potential of a pharmacological intervention in early bereavement.
Purpose of the Study:
- To determine if beta-blocker (metoprolol) and aspirin can reduce cardiovascular risk markers and anxiety in recently bereaved individuals.
- To assess if the intervention adversely affects bereavement intensity.
- To evaluate the safety and efficacy of low-dose metoprolol and aspirin during early bereavement.
Main Methods:
- A randomized, double-blind, placebo-controlled trial was conducted with 85 recently bereaved participants (spouses or parents).
- Participants received either metoprolol (25 mg) and aspirin (100 mg) or a placebo daily for 6 weeks.
- Cardiovascular risk markers, anxiety, and bereavement intensity were assessed using ANCOVA, adjusted for baseline values.
Main Results:
- Metoprolol and aspirin significantly reduced home systolic pressure, 24-hour average heart rate, anxiety symptoms, and platelet response to arachidonic acid compared to placebo.
- No significant differences were observed in heart rate variability (SDNNi), von Willebrand Factor antigen, platelet-granulocyte aggregates, or bereavement intensity.
- No significant adverse safety impacts were noted during the 6-week intervention period.
Conclusions:
- Low-dose metoprolol and aspirin effectively reduce physiological and psychological surrogate measures of cardiovascular risk in early bereavement.
- The intervention demonstrated a potential preventive benefit without negatively impacting the grieving process.
- Further research is warranted to confirm these findings and explore long-term effects.
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.
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