Patients who felt isolated and lonely had an increased risk for stroke and acute MI, as well as an increased risk for death after the event, according to a study published in Heart.
“These findings indicate that social isolation, similarly to other risk factors such as depression, can be regarded as a risk factor for poor prognosis of individuals with cardiovascular disease,” Christian Hakulinen, PhD, of the department of psychology and logopedics at the University of Helsinki in Finland, and colleagues wrote.
Researchers reviewed data from 479,054 participants (mean age, 56 years; 55% women) who were included in the UK Biobank between April 2007 and December 2010. The outcome of interest was acute MI or stroke.
Patients completed questionnaires and had biological samples and physical measurements taken. The questionnaires included questions on social isolation and loneliness.
During a mean follow-up of 7.1 years, 3,471 patients had stroke and 5,731 patients had an acute MI.
After adjusting for sex, age and ethnicity, patients who reported social isolation had an increased risk for acute MI (HR = 1.43; 95% CI, 1.32-1.55) and stroke (HR = 1.39; 95% CI, 1.25-1.54) compared with those who did not report it. The association was not statistically significant after adjusting for all risk factors (HR for acute MI = 1.07; 95% CI, 0.99-1.16; HR for stroke = 1.06; 95% CI, 0.96-1.19).
Loneliness was also associated with an increased risk for acute MI after adjusting for sex, age and ethnicity (HR = 1.49; 95% CI, 1.36-1.64), but was not statistically significant after adjusting for all risk factors (HR = 1.06; 95% CI, 0.96-1.17). The same pattern was seen for stroke (HR after adjustment for sex, age and ethnicity = 1.36; 95% CI, 1.2-1.55; HR after adjustment for all risk factors = 1.04; 95% CI, 0.91-1.19).
After adjusting for sex, age and ethnicity, social isolation was associated with an increased risk for mortality in patients with a history of acute MI (HR = 1.25; 95% CI, 1.03-1.51) or stroke (HR = 1.32; 95% CI, 1.08-1.61). The association was not seen in loneliness.
“Social isolation and loneliness can be seen as markers for many conventional risk factors, such as unhealthy lifestyles, poor mental health and socioeconomic adversity, and these risk factors also explain the association of social isolation and loneliness with cardiovascular morbidity,” Hakulinen and colleagues wrote. “Thus, public health policies addressing conventional risk factors might also reduce the cardiovascular morbidity related to social isolation and loneliness.” – by Darlene Dobkowski
: The authors report no relevant financial disclosures.