Many have heard the expression “She/he died of a broken heart” before, usually after someone has lost their spouse. Now, a new systematic study links the two.

While acute psychological stress is linked with a rapid increase in the risk of heart attack or other forms of cardiovascular events, intense grief after the death of a significant person may trigger the onset of acute myocardial infarction (MI), commonly known as a heart attack, finds a study published in the Journal of the American Heart Association.

“Grief over the death of a significant person was associated with an acutely increased risk of MI in the subsequent days. The impact may be greatest among individuals at high cardiovascular risk,” researchers said.

The researchers have found that from the day a person’s spouse has died their risk of having a heart attack is 21 times higher.

The study analyzed 1985 participants. Researchers found that 13.6 percent, 270 subjects, lost a significant person in the prior six months before having a heart attack, including 19 within 1 day of their heart attack.

They said that the rate of heart attack onset increased 21.1 percent within 24 hours of the death of a significant person, and declined steadily on each subsequent day.

For those with low, 5 percent 10-year heart attack risk the absolute risk of heart attack within 1 week of the death of a significant person are 1 excess heart attack per 1394 and 1 per 320 among individuals at high 20 percent 10-year risk.