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Association of Social Isolation and Loneliness With Incident Heart Failure in a Population-Based Cohort Study
Yannis Yan Liang1, Yilin Chen2, Hongliang Feng3
1Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China; Department of Neurology, the First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China.
Insights
Social isolation and loneliness independently increase heart failure risk. Loneliness may modify the impact of social isolation on heart failure development, regardless of genetic predisposition.
Area of Science:
- Cardiovascular Epidemiology
- Social Determinants of Health
- Gerontology
Background:
- Social isolation and loneliness are recognized risk factors for cardiovascular diseases.
- The specific associations with incident heart failure (HF), especially during the COVID-19 pandemic, require further clarification.
Purpose of the Study:
- To investigate the independent and combined associations of social isolation and loneliness with the risk of developing incident heart failure.
Main Methods:
- Utilized UK Biobank data, a large population-based cohort.
- Assessed social isolation and loneliness via self-report questionnaires.
- Identified incident HF cases through hospital records and death registries, controlling for genetic risk scores.
Main Results:
- Over 12.3 years, social isolation and loneliness were independently linked to increased incident HF risk.
- The association between social isolation and HF risk was significantly modified by loneliness status.
- A clear dose-response relationship between social isolation and HF risk was observed only in non-lonely individuals.
Conclusions:
- Both social isolation and loneliness are independent risk factors for incident heart failure, irrespective of genetic susceptibility.
- Loneliness may influence the relationship between social isolation and heart failure development.
Background:
Social isolation and loneliness have emerged as important risk factors for cardiovascular diseases, particularly during the coronavirus disease pandemic. However, it is unclear whether social isolation and loneliness had independent and joint associations with incident heart failure (HF).
Objectives:
This study sought to examine the association of social isolation, loneliness, and their combination with incident HF.
Methods:
The UK Biobank study is a population-based cohort study. Social isolation and loneliness were assessed using self-reported questionnaires. HF cases were identified by linking hospital records and death registries. The weighted polygenic risk score associated with HF was calculated.
Results:
Among the 464,773 participants (mean age: 56.5 ± 8.1 years, 45.3% male), 12,898 incident HF cases were documented during a median follow-up of 12.3 years. Social isolation (most vs least: adjusted HR: 1.17; 95% CI:1.11-1.23) and loneliness (yes vs no: adjusted HR: 1.19; 95% CI: 1.11-1.27) were significantly associated with an increased risk of incident HF. The association between an elevated risk of HF and social isolation was modified by loneliness (Pinteraction = 0.034). A gradient of association between social isolation and the risk of incident HF was found only among individuals without loneliness (Ptrend < 0.001), but not among those with loneliness (Ptrend = 0.829). These associations were independent of the genetic risk of HF.
Conclusions:
Social isolation and loneliness were independently associated with a higher likelihood of incident HF regardless of genetic risk. The association between social isolation and incident HF was potentially modified by loneliness status.
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