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(Circulation. 2002;106:1634.)
© 2002 American Heart Association, Inc.

Clinical Investigation and Reports

Myocardial Infarction in Parents Who Lost a Child

A Nationwide Prospective Cohort Study in Denmark

From The Danish Epidemiology Science Centre, Department of Epidemiology and Social Science (J.L., D.H., J.O.), University of Aarhus; National Institute of Public Health (D.H.), Copenhagen; and National Center for Register-based Research (P.B.M.), University of Aarhus, Denmark.

Correspondence to Dr Jiong Li, The Danish Epidemiology Science Centre, Department of Epidemiology and Social Medicine, University of Aarhus, Vennelyst Boulevard 6, DK-8000 Aarhus C, Denmark. E-mail jl{at}soci.au.dk

Background— The association between psychological stress and coronary heart disease remains unclear. We conducted a prospective follow-up study based on national registers to investigate if the death of a child, one of the most severe stressors, increases the risk of myocardial infarction (MI) in parents.

Methods and Results— From 1980 to 1996, 19 361 parents who lost a child (<18 years of age) in Denmark were recruited to the exposed cohort, and 295 540 parents matched on family structure were selected for the unexposed cohort. The Cox proportional hazards model was used to evaluate the relative risk (RR) of myocardial infarction (MI). The average RRs for a fatal MI and any first MI among the exposed were 1.36 (95% CI, 0.98 to 1.88) and 1.28 (95% CI, 1.08 to 1.51), respectively. The two cohorts had similar MI risk during the first 6 years of follow-up. From the 7th to the 17th year of follow-up, the exposed cohort had a RR of 1.58 (95% CI, 1.08 to 2.30) for fatal MI and a RR of 1.31 (95% CI, 1.09 to 1.57) for first MI. Parents who lost a child unexpectedly, especially from sudden infant death syndrome, experienced higher RRs.

Conclusions— The death of a child was associated with an increased risk of MI in bereaved parents.

Key Words: myocardial infarction • stress • risk factors

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