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

Heart - Tập 104 Số 18 - Trang 1536-1542 - 2018
Christian Hakulinen1, Laura Pulkki‐Råback1, Marianna Virtanen2,3, Markus Jokela1, Mika Kivimäki4,5, Marko Elovainio1,6
1Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
2Department of Public Health and Caring Sciences, University of Uppsala, Uppsala, Sweden
3Finnish Institute of Occupational Health, Helsinki, Finland
4Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
5Department of Epidemiology and Public Health, University College London, London, UK
6National Institute for Health and Welfare, Helsinki, Finland

Tóm tắt

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

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Heart

Tập 104 Số 18

1536-1542

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