The Heart of the Matter: How Social Isolation and Loneliness Impact Cardiovascular Health
“Human beings are wired to connect.” Neuroscience suggests that minor neurons in our brains are stimulated when we interact with others. Social isolation during COVID-19 pandemic has emphasized the importance of psychosocial determinants of cardiovascular diseases. Is social isolation and loneliness a health pandemic?
A wave of new research on the health impact of social connection has tried to address this question. In 2023, researchers from UK published a study showing the association of social isolation and loneliness with incident heart failure on over 400,000 adults between 40 and 69 years. Social isolation was defined as “being objectively alone or having infrequent social connections, and loneliness was defined as “a painful feeling caused by a discrepancy between one’s desire for connections and the actual degree of connections”. They found that even when other known risk factors are controlled for (such as age, sex, and other socioeconomic factors), social isolation and loneliness increased the risk of developing heart failure by 15-20% in a dose-dependent manner. Living alone contributed to the greatest risk of heart failure. The associations between social isolation and loneliness and incident of heart failure were independent of individual’s genetic risk of heart failure.
Social isolation and loneliness may precipitate unhealthy lifestyles (physical inactivity, alcohol addiction) and hinder older adults from getting social support or seeking health care resources. Social isolation and loneliness are associated with increased activity of hypothalamic-pituitary-adrenal axis and sympathetic nervous system, enhanced inflammatory and oxidative stress which all in turn may accelerate atherosclerosis leading to cardiac remodeling preceding heart failure.
The study is a call to action. To address heart failure and the health pandemic that social disconnectedness has created, there is an urgent need for community-level strategies aimed at reducing social isolation and loneliness.
The power of social connection pillar of lifestyle medicine, your HEART depends on it! It is easier than you think. Let’s start from ourselves, find what works for you: increase contact with family and friends, join groups or clubs (sports club, gym, group activity) and use social media in a positive way to connect with others (join local support group, learn what’s happening in your community).
By: Helena Zhang and Rusly Harsono, MD
- Reference: Liang YY, Chen Y, Feng H, Liu X, Ai QH, Xue H, Shu X, Weng F, He Z, Ma J, Ma H, Ai S, Geng Q, Zhang J. Association of Social Isolation and Loneliness With Incident Heart Failure in a Population-Based Cohort Study. JACC Heart Fail. 2023 Jan 20:S2213-1779(23)00026-4. doi: 10.1016/j.jchf.2022.11.028. Epub ahead of print. PMID: 36737310; PMCID: PMC9891238.