After a loved one passes, don’t stay alone for the first few days. Those with heart disease, high blood pressure, or diabetes should keep taking their medication. If you feel pressure or pain in the chest, call 120 right away

There is no cost involved. Just avoid being alone during these days and keep taking your medicine as usual.

Both extra-case estimates below refer to the first week after bereavement. 1985 patients with an acute heart attack, comparing different stretches of time in the same person, before and after the attack. Of them, 270 (13.6%) had lost an important person in the 6 months before the attack, and 19 had lost that person within 1 day before the heart attack. Within 24 hours after an important person died, the rate of acute heart attack was 21.1 times baseline (95% CI 13.1–34.1, and the true multiple sits roughly between 13 and 34). After that it fell day by day. In actual counts: among people with a decade-long heart-attack risk of 5%, each 1394 people who had just lost a relative produced 1 extra case. Among people with a risk of 20%, each 320 people produced 1 extra case. Another study in Britain compared 30447 widowed people aged 60 to 89 with 83588 controls in similar circumstances. Within 30 days after the death of the spouse, a heart attack or a stroke occurred in 50 people on the widowed side (0.16%) and in 67 people on the control side (0.08%). The incidence rate ratio IRR was 2.20 (1.52–3.15), that is, the chance of the event was about 2.2 times the control group. Of that, heart attack was 2.14 (1.20–3.81), about 2.1 times. Stroke was 2.40 (1.22–4.71), about 2.4 times. After 30 days it weakened. Within 90 days they also looked at further illnesses. The first was acute coronary syndrome that was not a heart attack (an acute problem with the blood supply to the heart that still falls short of a heart attack), IRR 2.20 (1.12–4.29). The other was pulmonary embolism (a clot blocking a blood vessel in the lung), IRR 2.37 (1.18–4.75). The British National Health Service (NHS) lists the signs for which you should call the emergency number at once. A heart attack is pain in the chest as if it were being pressed or squeezed. The pain can spread to the arm, the neck, or the jaw, and there is also shortness of breath. A stroke is a side of the face drooping, an arm or a side of the body weak or numb, and slurred speech.

Mostofsky E, et al. (2012). Risk of acute myocardial infarction after the death of a significant person in one's life: the Determinants of Myocardial Infarction Onset Study. Circulation. https://doi.org/10.1161/CIRCULATIONAHA.111.061770；Carey IM, et al. (2014). Increased risk of acute cardiovascular events after partner bereavement: a matched cohort study. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2013.14558；NHS. Heart attack: symptoms. https://www.nhs.uk/conditions/heart-attack/symptoms/；NHS. Symptoms of a stroke. https://www.nhs.uk/conditions/stroke/symptoms/

Continuing usual medicines for hypertension or diabetes is the author’s judgment. Neither study compared taking with not taking medicines. The 21.1-times study only converted baseline heart-attack risk into extra case counts. Practical steps are easy to follow: ask someone else to manage your medication rather than relying on memory alone. Avoid long-distance driving during this period, and do not try to cope by drinking alcohol — details on alcohol’s effects are covered in Section 2. Recognizing heart attacks and strokes, plus instructions on calling emergency services, are explained in Section 13. Both studies referenced here rely on retrospective population data, so it’s hard to determine exactly how many participants would have developed these conditions anyway. Yet both studies point to the same general trend and timeframe. For anyone unable to arrange help or who must remain alone during these days, please see point 6 in this section.