Loneliness, Social Isolation Tied to Increased Risk of Cardiovascular Disease in Postmenopausal Women


An analysis of WHI data indicates social isolation and loneliness were associated with significant increases in risk of major cardiovascular disease, even after adjustment for other clinical risk factors.

Natalie Golaszewski, PhD, UCSD

Natalie Golaszewski, PhD

A new study assessing the impact of social isolation and loneliness is underlining the increased risk of cardiovascular disease associated with increased isolation and loneliness among aging women.

The study, which assessed data from Women’s Health Initiative (WHI), evaluated nearly 60,000 without a history of cardiovascular events and found risk of cardiovascular disease was 16% greater among those with high levels of social isolation, 11% greater in those with high levels of loneliness, and 29% greater in those reporting both.

“People who experience social isolation or loneliness tend to withdraw and don’t engage often in healthy behaviors, which may become a cyclical pattern. Over time, the unhealthy behaviors coupled with social isolation and feeling lonely put them at an increased risk for cardiovascular disease,” Natalie Golaszewski, PhD, a postdoctoral fellow at the Herbert Wertheim School of Public Health and Human Longevity Science at University of California San Diego, in a statement.

Funded by the National Institute of Aging of the National Institutes of Health, the current study provides new insight into the relationship between social well-being and risk of cardiovascular disease at a time when reports of social isolation and loneliness are at an all-time high as a result of the pandemic. Investigators designed their study to use information from women in the WHI who were free from cardiovascular disease at baseline and had complete information related to assessments of social activities, living status, marital status, loneliness, and social support from 2014-2015.

Of note, loneliness was assessed using the 3-item UCLA Loneliness Scale and social isolation was assessed using an index scored derbies from questions related to personal relationships and social activities.

A cohort of 57,825 women, with a mean age of 79±6 years and follow-up of up to 4 years, was identified for inclusion. For the purpose of analysis, the primary outcome of interest for the study was major cardiovascular disease, which investigators defined as myocardial infarction, stroke, and cardiovascular disease death. Investigators noted hazard ratios for risk were estimated for 1-IQR increment in isolation and loneliness using 3 progressively adjusted Cox proportional hazard models.

Over 186,762 person-years of follow-up, 1599 incident major cardiovascular disease events were identified by investigators. In fully adjusted models, results indicated each 1-IQR increment in social isolation and loneliness increased cardiovascular disease risk by 7% (HR, 1.07; 95% CI, 1.03-1.12) and 5% (HR, 1.05; 95% CI, 1.01-1.09), respectively. Investigators pointed out further analysis revealed the presence of social support did not appear to be a modifier of either association (P >.05).

“Our results suggest measures of social isolation and loneliness, even with brief questions, should be incorporated into standard care,” Golaszewski said. “We monitor our patients’ blood pressure, weight and temperature, and it might also be beneficial to capture the social needs that women may be lacking — to better understand cardiovascular risk and develop solutions.”

This study, “Social Isolation, Loneliness, And Cardiovascular Disease Among Older Women In The Women’s Health Initiative,” was presented at the AHA EPI Lifestyle Conference 2021.

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