In the first days after a loved one dies, don't be alone; if you have heart disease, high blood pressure or diabetes, keep taking your medicine, and call 120 (China's ambulance number) if your chest feels crushed

If you are thinking about suicide right now, call or text 988. If you are in immediate danger, call 911.

Cost

Free. Don't be alone these days, and keep taking your medicine.

What you get

1985 patients with acute heart attack were compared with themselves, at different time periods before and after the attack. Among them, 270 (13.6%) had lost someone important in the 6 months before the attack, and 19 lost them within 1 day before the heart attack. In the 24 hours after the death of someone important, the rate of acute heart attack was 21.1 times higher (95% CI 13.1–34.1, so the true multiple likely lies between 13 and 34). It then fell day by day. In terms of actual people: among people with a 5% ten-year heart attack risk, there is 1 extra case for every 1394 people who have just lost someone. Among people with a 20% risk, 1 extra case for every 320. Another study, in the U.K., compared 30447 bereaved people aged 60 to 89 who lost a spouse with 83588 matched controls. Within 30 days after the loss of a spouse, a heart attack or stroke occurred in 50 people (0.16%) on the bereaved side and 67 people (0.08%) on the control side. IRR 2.20 (1.52–3.15), meaning the chance of an event was about 2.2 times that of the controls. Of this, 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. The effect weakened after 30 days. Within 90 days, two other conditions were also looked at. One was acute coronary syndrome other than heart attack (a sudden problem with the heart's blood supply that falls short of a heart attack), IRR 2.20 (1.12–4.29). The other was pulmonary embolism (a blood clot blocking a blood vessel in the lung), IRR 2.37 (1.18–4.75).

Notes

Let someone else manage the pill box; don't rely on remembering yourself. Don't take long drives these days. Don't use alcohol to get through it; for the account of alcohol, see §2. For how to recognize a heart attack or stroke and how to call for a vehicle, see §13. Both are studies that look back through population data, and it can't be told how many of those people were about to fall ill anyway. But the two point in the same direction and the same time period. For those who have no one to hand the pill box to and are bound to be alone in the house these days, see §29.6.

Evidence grade

A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.

Sources

1. 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
2. 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

Translated from the Chinese original. Original book, section 29, tip 1. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer