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Heart. 2018 Sep;104(18):1536-1542. doi: 10.1136/heartjnl-2017-312663. Epub 2018 Mar 27.

Social isolation and loneliness as risk factors for myocardial infarction, stroke and mortality: UK Biobank cohort study of 479 054 men and women.

Author information

1
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
2
National Institute for Health and Welfare, Helsinki, Finland.
3
Finnish Institute of Occupational Health, Helsinki, Finland.
4
Department of Public Health and Caring Sciences, University of Uppsala, Uppsala, Sweden.
5
Department of Epidemiology and Public Health, University College London, London, UK.
6
Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.

Abstract

OBJECTIVE:

To examine whether social isolation and loneliness (1) predict acute myocardial infarction (AMI) and stroke among those with no history of AMI or stroke, (2) are related to mortality risk among those with a history of AMI or stroke, and (3) the extent to which these associations are explained by known risk factors or pre-existing chronic conditions.

METHODS:

Participants were 479 054 individuals from the UK Biobank. The exposures were self-reported social isolation and loneliness. AMI, stroke and mortality were the outcomes.

RESULTS:

Over 7.1 years, 5731 had first AMI, and 3471 had first stroke. In model adjusted for demographics, social isolation was associated with higher risk of AMI (HR 1.43, 95% CI 1.3 to -1.55) and stroke (HR 1.39, 95% CI 1.25 to 1.54). When adjusted for all the other risk factors, the HR for AMI was attenuated by 84% to 1.07 (95% CI 0.99 to 1.16) and the HR for stroke was attenuated by 83% to 1.06 (95% CI 0.96 to 1.19). Loneliness was associated with higher risk of AMI before (HR 1.49, 95% CI 1.36 to 1.64) but attenuated considerably with adjustments (HR 1.06, 95% CI 0.96 to 1.17). This was also the case for stroke (HR 1.36, 95% CI 1.20 to 1.55 before and HR 1.04, 95% CI 0.91 to 1.19 after adjustments). Social isolation, but not loneliness, was associated with increased mortality in participants with a history of AMI (HR 1.25, 95% CI 1.03 to 1.51) or stroke (HR 1.32, 95% CI 1.08 to 1.61) in the fully adjusted model.

CONCLUSIONS:

Isolated and lonely persons are at increased risk of AMI and stroke, and, among those with a history of AMI or stroke, increased risk of death. Most of this risk was explained by conventional risk factors.

KEYWORDS:

cardiac risk factors and prevention; epidemiology; stroke

PMID:
29588329
DOI:
10.1136/heartjnl-2017-312663
[Indexed for MEDLINE]

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