Social isolation and loneliness increase risk of death from heart attack and stroke

“More than 40 years of research have clearly shown that both social isolation and loneliness are associated with adverse health effects,” said the chair of the scientific statement writing group, clinical medicine and said Crystal Wiley Cené, MD, MPH, FAHA, professor of clinical medicine. Chief Executive Officer for Health Equity, Diversity and Inclusion at the University of California, San Diego. “Given the prevalence of social distancing across the United States, the public health implications are enormous.”

The risk of social isolation increases with age due to living factors such as widowhood and retirement. Nearly a quarter of adults in the United States over the age of 65 are socially isolated, and the prevalence of loneliness is even higher, estimated at 22% to 47%. But young adults also experience social isolation and loneliness. A study for her Making Caring Common project at Harvard University described “Generation Z” (adults currently aged 18-22) as the loneliest generation. Increased isolation and loneliness among young adults can be attributed to higher social media usage and less engagement in meaningful face-to-face activities.

The data also suggest that social isolation and loneliness may have increased during the COVID-19 pandemic, especially among young adults aged 18 to 25, older adults, women, and low-income individuals. I’m here.

Social isolation is defined as infrequent direct contact with people for social relationships, such as family, friends, or members of the same community or religious group. Loneliness is when you feel alone or less connected to others than you would like. “Social isolation and loneliness are related, but not the same thing,” Sene explains. “Individuals live relatively isolated lives and do not feel lonely. Conversely, people with many social contacts may still experience loneliness.”

The writing group reviewed studies on social isolation published up to July 2021 to examine the relationship between social isolation and cardiovascular and brain health. they found:

• Social isolation and loneliness are common, but the determinants of cardiovascular and brain health are poorly recognized.
• Lack of social ties is associated with an increased risk of premature death from all causes, especially in men.
• Isolation and loneliness were associated with elevated inflammatory markers, and people with less social ties were more likely to experience physiological symptoms of chronic stress.
• When assessing risk factors for social isolation, the relationship between social isolation and its risk factors goes both ways. Depression can lead to social isolation, and social isolation can make you more likely to experience depression.
• Childhood social isolation is associated with increased cardiovascular risk factors in adulthood, including obesity, hypertension, and elevated blood sugar levels.

Transportation, living arrangements, dissatisfaction with family relationships, and socio-environmental factors such as pandemics and natural disasters are also factors that affect social ties.

“In general, there is strong evidence linking social isolation and loneliness to an increased risk of worsening heart and brain health. are sparse,” Cené said.

The evidence is most consistent for an association between social isolation, loneliness, and death from heart disease and stroke, with a 29% increased risk of heart attack and/or death from heart disease, and a 29% increased risk of stroke and death from stroke. “Social isolation and loneliness are also associated with poor prognosis in individuals who already have coronary heart disease or stroke,” Cené added.

Mortality in heart patients who were socially isolated increased 2- to 3-fold over 6 years of follow-up. If a socially isolated adult has three or fewer social contacts with her per month, she may have a 40% higher risk of recurrent stroke or heart attack. In addition, 5-year heart failure survival was significantly higher in socially isolated individuals (60%) and in those who were socially isolated and clinically depressed (62%) with more social contact and lower than those who did not. depressed (79%).

Social isolation and loneliness are also associated with behaviors that adversely affect cardiovascular and brain health, such as lower self-reported levels of physical activity, reduced fruit and vegetable intake, and increased sedentary time. . Multiple large studies have found a significant association between loneliness and being more likely to smoke.

“There is an urgent need to develop, implement, and evaluate programs and strategies to reduce the negative effects of social isolation and loneliness on cardiovascular and brain health, especially for at-risk populations.” Physicians should ask patients whether they are satisfied with the frequency of their social activities and level of interaction with friends and family. We need to be prepared to refer someone with an illness or stroke — to community resources to help them connect with others.”

Some populations are more vulnerable to social isolation and loneliness, and more research is needed to understand how social isolation affects cardiovascular and brain health in these groups. Bisexual, transgender, and queer (LGBTQ) people; people with disabilities; restricted, recent immigrants, imprisoned.

This review focuses on research in older adults aimed at reducing social isolation and loneliness. These studies show that fitness programs and recreational activities in senior centers and interventions that address negative self-esteem and other negative thoughts show promise in reducing isolation and loneliness. It turns out that

This review did not identify any studies aimed at reducing social isolation with the specific goal of improving cardiovascular health.

“It is unclear whether being isolated (social isolation) or feeling isolated (loneliness) is most important for cardiovascular and brain health. Because there are very few,” Cené said. “Examining the links between social isolation, loneliness, coronary heart disease, stroke, dementia and cognitive impairment to better understand the mechanisms by which social isolation and loneliness affect cardiovascular and brain health. We need more research.”

This scientific statement was prepared by a volunteer writing group on behalf of the Social Determinants and Care Quality and Outcomes Research Council of the Health Committee of the American Heart Association’s Council on Epidemiology and Prevention. Preventive Scientific Committee of the Council on Epidemiology and Prevention and the Council on Care Quality and Outcomes Research; Preventive Scientific Committee of the Council on Epidemiology and Prevention and the Council on Cardiovascular and Stroke Nursing; Council on Arteriosclerosis, Thrombosis and Vascular Biology meeting. and the Stroke Council.

Scientific statements from the American Heart Association help raise awareness and facilitate informed health care decisions about cardiovascular disease and stroke issues. A scientific statement outlines what is currently known about the topic and areas where additional research is needed. Scientific statements inform the development of guidelines but do not make treatment recommendations. The American Heart Association guidelines provide the association’s official clinical practice recommendations.

Co-authored by Vice Chair Theresa M. Beckie, Ph.D., FAHA. Mario Sims, Ph.D., FAHA; Shakira F. Suglia, Sc.D., MS, FAHA. Brooke Aggarwal, Ed.D., MS, FAHA; Natalie Moyes, M.D.; Monik C. Jiménez, SM, Sc.D., FAHA. Dr. Bamba Gay. and Louise D. McCullough, MD, Ph.D. Author disclosures are provided in the manuscript.