Low-dose aspirin reduces cardiovascular baseline risk, reactivity, and depressed mood in acutely bereaved

Abstract

Objective: The death of a loved one is extremely stressful, and cardiovascular risk increases nearly two-fold in the acute period of bereavement. However, no studies have attempted to intervene to reduce risk during this identifiable period. This pilot study investigated the protective effect of low-dose aspirin on cardiovascular parameters and depressed mood of bereaved participants, compared to nonbereaved healthy controls. Methods: Ten bereaved participants and 12 nonbereaved control participants had blood pressure, heart rate and heart rate variability (HRV) measured and blood drawn at a first laboratory visit. The visit was within 30 days of the death of their spouse, on average. Participants were randomized to receive low-dose aspirin (81 mg) or placebo, taken for five days. In a second laboratory visit, the same assessments were repeated, as well as a structured separation recall reactivity task (i.e., recalling a time they felt alone or abandoned). Bereaved participants recalled their bereavement experience. Results: Bereaved participants taking aspirin were more likely to report a decrease in CES-D score from the first to the second laboratory visit than those taking placebo (χ2=6.67, p<0.01, d=3.54). Levels of P-selectin (-0.12 vs. +0.16, p<0.01, d=1.22) and a composite cardiovascular risk score (-0.30 vs. +0.38, p<0.03, d=1.02) decreased more from the first to the second lab visit in participants taking aspirin. In response to the separation recall, participants taking aspirin recovered faster than those taking placebo: heart rate decreased more in the aspirin group (-2.32 vs. -5.97 beats per minute, p<0.005, d=1.64) and HRV decreased in the placebo group while it increased in the aspirin group (log RSA +0.42 vs. -0.17, p<0.03, d=1.18). Conclusions: The present pilot study was the first to measure reactivity in a bereaved population using a laboratory stress task. The results suggest that aspirin can reduce baseline cardiovascular risk markers, attenuate physiological reactivity to stressors, and ameliorate depressed mood in acutely bereaved.