Mikael Rostila, PhD

JAHA: Tell us about the key findings from your recent article in JAHA.

Dr. Rostila: 

-  Surviving women were 25 percent and men 15 percent more likely to die from heart attack after the death of a sibling, compared to people who had not lost a sibling.

-  Increased risk of death from heart attack was four to six and a half years after the death of a sibling among women and two to six and a half years after among men.

-  No notable increased risk of heart attack occurred immediately after their siblings died.

-  If their sibling died of heart attack, the risk of heart attack death in the following years rose 62 percent among women and 98 percent among men.

JAHA: What are the major implications of this work?

Dr. Rostila: Healthcare providers should follow bereaved siblings to help recognize signs of acute or chronic psycho-social stress mechanisms that could lead to heart attack. We might be able to prevent heart attacks and other heart-related conditions by treating these siblings early on and recommending stress management.

JAHA: How did you get the idea to do this study?

Dr. Rostila: During my career I have been interested in the links between social networks and health, for instance, I wrote my thesis about social capital and health. However, it is not only the presence of a social relationship that could have severe health effects. Also the loss of a relationship could influence health. A family may be considered the simpliest form of a social network and the loss of a family member could therefore be considered a traumatic and stressful event. While previous studies have examined whether the loss of other family members might trigger myocardial infarction, the impact of grief following the loss of an adult sibling has been largely overlooked. To the extent that siblings are also beloved, provide companionship and support, one would expect that death of an adult sibling -- as much as the death of other family members (e.g. spouse, parents, children) – could be considered a stressful life event

JAHA: What was your biggest obstacle in completing this study?

Dr. Rostila: Despite the obvious strengths of the use of total population register data such data does not include detailed individual information that is required to uncover the actual causal mechanisms that link sibling deaths and myocardial infarction. Ideally, one would like to have access to biological and genetic data, detailed information on diseases from medical records, more information on shared childhood social environment and family characteristics and detailed data on personal and relational characteristics which is unfortunately not included in the registers

JAHA: What was your most unexpected finding?

Dr. Rostila: That our results suggest that this association between the loss of a sibling and having a heart attack is more likely to occur some years after bereavement. Most previous studies suggest that bereavement could trigger myocardial infarction through acute psycho-physiological stress mechanisms ("the so called broken heart syndrome"). Deaths from broken-heart usually appear within the first few hours and days after a stressful event while our findings suggests effects in the longer-term.

JAHA: What do you plan to do next, based on these current findings?

Dr. Rostila: The loss of a parent at adult ages - as a trigger of myocardial infarction - is also rarely studied. In the future we therefore aim to study whether parental loss could increase the risk of myocardial infarction in the shorter and longer-term. We are however also interested in how sibling loss influence other diseases and causes of death such as suicide, stroke, and cancer.

JAHA: What do you like to do in your free time?

Dr. Rostila: I enjoy exercise like running and going to the gym. I also enjoy travelling and experiencing new countries and cultures. I have two small children so of course I want to spend as much time as possible with them during my free time.

JAHA: What is your favorite sports team or musical group?

Dr. Rostila: In particular i follow the Swedish national team in Ice hockey and soccer since I am Swedish. My local favorite team in soccer and Ice hockey is Djurgården from Stockholm, Sweden. I enjoy all kinds of contemporary music but U2, Coldplay and Bruce Springsteen have been my favorites for a long time.

To read Dr. Rostila's full article, click here

Profile originally published April 16, 2013