Death of a partner associated with subsequent increase in ischemic stroke and intracerebral hemorrhage

1. Partner death was associated with both ischemic stroke and intracerebral hemorrhage in the subsequent five years, though absolute risk differences were small.

2. Risk of intracerebral hemorrhage was particularly elevated within the first 30 days following partner death.

Evidence Rating Level: 2 (Good)

Stress can have a negative impact on various systems, including but not limited to the nervous and cardiovascular systems. One particularly stressful event, among many, is the death of a partner. In the context of COVID-19, stress and the potential for the death of a partner are significantly increased. This Danish cohort study sought to investigate the relationship between death of a partner and subsequent ischemic stroke (IS) and intracerebral hemorrhage (ICH). A total of 278,758 Danish participants had experienced the death of a partner between 2002 and 2016, which were matched with cohabiting individuals matched 1:2 on age, sex, and calendar time (n = 557,516). Approximately one-third of each group were between the ages of 70 and 80 years. Follow-ups occurred for up to five years. During the study, 7,684 (2.76%) participants experienced an IS within five years of partner death (adjusted HR [aHR] = 1.11, 95% CI 1.08 to 1.14) and 1,139 (.410%) experienced an ICH (aHR = 1.13, 95% CI 1.04 to 1.23) within the five years following partner death. This association appeared to be strongest within the first 30 days following partner death (aHR = 1.66, 95% CI 1.06 to 2.61). While statistical precision was low, women, specifically, were at a higher risk during the first 30 days (aHR = 1.99, 95% CI 1.06 to 3.75). In terms of cumulative incidence, IS and ICH were both more common than those who did not experience partner death (differences, 0.1 per 1,000 and .05 per 1,000, respectively). Overall, this study suggests that partner death is a significant risk factor for IS and ICH, particularly the latter in 30 days following partner death. However, absolute risk differences were relatively small. In the context of the current pandemic, this is a noteworthy consideration that should be considered, particularly among populations at increased risk for IS and ICH.

Click to read the study in JAHA

Image: PD
