Abstract 15380: A Randomized Double Blind Placebo Controlled Trial of Metoprolol and Aspirin in Early Bereavement
Introduction: Bereavement has been associated with an increased risk of cardiovascular disease (CVD), with a fourfold higher rate of non-fatal myocardial infarction in the first month. However, no reports exist of interventions to reduce CVD risk during this period. In the Cardiovascular Risk in Bereavement study (CARBER 1) we reported that within 2 weeks of death, spouses or parents of deceased experienced elevated haemodynamic forces (heart rate (HR) and blood pressure [BP]), reduced heart rate variability (HRV), prothrombotic changes and increased psychological distress compared with non-bereaved controls.
Hypothesis: We hypothesized that administration of low dose metoprolol (25mg mane) and aspirin (100mg mane) would have a beneficial effect on CVD risk, without a deleterious effect on psychological state during early bereavement (CARBER 2 study).
Methods: 85 participants were enrolled. They were aged 66.1 (SD 9.4) years, and comprised 55 females, 30 males, 73 spouses and 12 parents of deceased from Northern Sydney Area Hospitals. Initial assessment within 2 weeks of bereavement included; 24 hour Holter monitor (HR and HRV (mean of standard deviations of all normal to normal intervals in all 5-minute segments [SDNNi] , and root-mean square differences of successive R-R intervals [rMSSD]), home BP (average of morning, afternoon and evening readings), blood measures, symptoms of grief (CBI-17), depression (CESD) and anxiety (STAI). Subjects were then randomised to 6 weeks of daily therapy (metoprolol and aspirin) or matching placebo, then a repeat assessment. *p value <0.05 for pre-randomisation versus 6-weeks within-groups.
Results: Findings are presented in the table.
Conclusions: The combination of low dose metoprolol and aspirin reduces physiological and psychological measures of CVD risk. Although further research is needed, this therapy represents a potential preventive approach during early bereavement: a period of increased CVD risk.
Author Disclosures: G. Tofler: None. M. Spinaze: None. J. Dent: None. M. Morel-Kopp: None. R. Bartrop: None. C. Ward: None. S. McKinley: None. A. Mihailidou: None. J. Havyatt: None. V. Whitfield: None. J. Fethney: None. H. Prigerson: None. T. Buckley: None.
- © 2016 by American Heart Association, Inc.