Does the risk of hospitalisation for ischaemic heart disease rise already before widowhood?

BACKGROUND: The death of a spouse has been shown to increase mortality from various causes, including ischaemic heart disease. It is unclear, however, whether cardiac problems are already on the rise before widowhood.

METHODS: Using longitudinal register data of Finnish widows-to-be aged 65 and over at baseline (N=19 185), we assessed the risk of hospitalisation for ischaemic heart disease 18 months before and after widowhood. Hospital admissions were derived from national hospital discharge registers between 1996 and 2002. Analyses used population-averaged and fixed-effects logistic models, the latter of which controlled for unobserved time-invariant characteristics, such as genetic susceptibility, personality and behavioural and medical history.

RESULTS: For men, fixed-effects model revealed that hospitalisation for ischaemic heart disease increased twofold already 0-3 months prior to the death of a spouse (OR=2.09, 95% CI 1.22 to 3.60), relative to the period of 15-18 months before widowhood. It stayed at a heightened level up to 6 months following bereavement (OR=2.15, 95% CI 1.07 to 4.30). Among women, the fixed-effects analysis detected no statistically significant increase in hospitalisation for ischaemic heart disease before or after widowhood.

CONCLUSIONS: These findings indicate that men are already vulnerable to cardiac problems before the death of a wife. Medical interventions and health counselling could be targeted to the husbands of terminally ill patients, in order to improve their cardiovascular health over the transition to widowhood.