More than a feeling? Social isolation, loneliness linked to a higher heart failure risk
Social isolation and loneliness are both independently linked to a heightened risk of developing heart failure, according to new research published in JACC: Heart Failure.[1]
In addition, the study’s authors noted, feeling lonely appears to influence a person’s risk of heart failure more than literally being alone.
“These findings indicate that the impact of subjective loneliness was more important than that of objective social isolation,” senior author Jihui Zhang, MD, PhD, a specialist with Guangzhou Medical University in China, said in a prepared statement. “These results suggest that when loneliness is present, social isolation is no more important in linking with heart failure. Loneliness is likely a stronger psychological stressor than social isolation because loneliness is common in individuals who are hostile or have stressful social relationships.”
Zhang et al. explored data from more than 460,000 patients who participated in the U.K. Biobank study. For the sake of this analysis, social isolation was defined as “being objectively alone or having infrequent social connections.” Loneliness, on the other hand, was defined as “a painful feeling caused by a discrepancy between one’s desire for connections and the actual degree of connections.” Participants indicated if they experienced social isolation or loneliness by answering questionnaires.
Overall, the team found, there were nearly 13,000 reported cases of heart failure among the study’s participants over 12.3 years of follow-up. Social isolation and loneliness both increased a participant’s risk of heart failure by up to 20%. This was true no matter what the person’s genetic heart failure risk may have been at the time.
“We shall pay more attention to those individuals feeling lonely for intervention,” Zhang added in the same statement. “For individuals who do not feel lonely, we shall screen for social isolation.”
Read the full analysis here.
Is there a place for social care in modern healthcare models?
In a separate editorial, co-authors Sarah J. Goodlin, MD, and Sheldon H. Gottlieb, MD, noted that social isolation and loneliness have been popular topics among poets for “thousands of years.”
Goodlin, with Patient-Centered Education and Research, and Gottlieb, a professor with Johns Hopkins University School of Medicine, also wrote that researchers have known for quite some time—though perhaps not thousands of years—that there are clear links between social interactions and cardiovascular health.
“There is a well-documented, strong association between social relationships, socioeconomic status, and cardiometabolic disease,” the duo wrote. “Some have suggested that the mechanism for the association of social isolation and/or loneliness with cardiovascular disease is activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenocortical axis. Risk for loneliness and social isolation and their negative influences on health are associated with poorer socioeconomic status and mental illness.”
Exploring this latest analysis focused on heart failure, the two co-authors examined ways that modern healthcare systems can work to help patients from taking on these additional risks.
“Because social determinants of health are increasingly recognized as important components of patient-centered health care, it may be appropriate to incorporate specific interventions, such as ‘social prescribing’ into care,” they wrote. “Addressing loneliness, social isolation and other social determinants of health will require transformation of health care delivery to integrate social care. We suggest that the current focus on loneliness and social isolation is a ‘call to action’ for healthcare delivery systems, insurers and others involved in population health.”
Read their full editorial here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.