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Significantly increased risk of all-cause mortality among cardiac patients feeling lonely

Anne Vinggaard Christensen1, Knud Juel2, Ola Ekholm2

  • 1Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark anne.vinggaard.christensen@regionh.dk.

Heart (British Cardiac Society)
|November 6, 2019
PubMed

Insights

Loneliness is linked to worse outcomes and higher mortality in cardiac patients. Public health and clinical assessments should prioritize addressing loneliness in these individuals.

Area of Science:

  • Cardiology
  • Public Health
  • Psychosocial Medicine

Background:

  • Social isolation and loneliness are increasingly recognized as significant factors impacting health.
  • Cardiac patients face unique challenges that may be exacerbated by social factors like loneliness.
  • Understanding the link between social determinants and cardiac health is crucial for effective patient management.

Purpose of the Study:

  • To investigate the association between living alone and loneliness with patient-reported outcomes at hospital discharge.
  • To determine if loneliness predicts cardiac events and all-cause mortality one year post-discharge in patients with cardiovascular diseases.
  • To examine these associations separately in men and women with ischaemic heart disease, arrhythmia, heart failure, or heart valve disease.

Main Methods:

  • A national cross-sectional survey of 13,443 cardiac patients at hospital discharge.
  • Inclusion of national register data for baseline and 1-year follow-up, assessing cohabitation status.
  • Utilized validated questionnaires for patient-reported outcomes (Short Form-12, Hospital Anxiety and Depression Scale, HeartQoL) and national registers for clinical outcomes (cardiac events, mortality).

Main Results:

  • Loneliness was significantly associated with poorer patient-reported outcomes in both men and women across all cardiac diagnoses.
  • Loneliness predicted all-cause mortality in both women (HR 2.92) and men (HR 2.14) at 1-year follow-up.
  • Living alone predicted cardiac events in men (HR 1.39) but not in women.

Conclusions:

  • A strong association exists between loneliness, poor patient-reported outcomes, and 1-year mortality in cardiac patients.
  • Loneliness should be a public health priority and integrated into clinical risk assessments for cardiovascular patients.
  • These findings highlight the critical role of social well-being in the management and prognosis of heart disease.
Abstract

Keywords:
coronary artery diseaseepidemiologyheart failurevalvular heart disease

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