Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies
BackgroundThe influence of social relationships on morbidity is widely accepted, but the size of the risk to cardiovascular health is unclear.ObjectiveWe undertook a systematic review and meta-analysis to investigate the association between loneliness or social isolation and incident coronary heart...
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| Published in | Heart (British Cardiac Society) Vol. 102; no. 13; pp. 1009 - 1016 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
BMJ Publishing Group LTD
01.07.2016
BMJ Publishing Group |
| Series | Original article |
| Subjects | |
| Online Access | Get full text |
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| Abstract | BackgroundThe influence of social relationships on morbidity is widely accepted, but the size of the risk to cardiovascular health is unclear.ObjectiveWe undertook a systematic review and meta-analysis to investigate the association between loneliness or social isolation and incident coronary heart disease (CHD) and stroke.MethodsSixteen electronic databases were systematically searched for longitudinal studies set in high-income countries and published up until May 2015. Two independent reviewers screened studies for inclusion and extracted data. We assessed quality using a component approach and pooled data for analysis using random effects models.ResultsOf the 35 925 records retrieved, 23 papers met inclusion criteria for the narrative review. They reported data from 16 longitudinal datasets, for a total of 4628 CHD and 3002 stroke events recorded over follow-up periods ranging from 3 to 21 years. Reports of 11 CHD studies and 8 stroke studies provided data suitable for meta-analysis. Poor social relationships were associated with a 29% increase in risk of incident CHD (pooled relative risk: 1.29, 95% CI 1.04 to 1.59) and a 32% increase in risk of stroke (pooled relative risk: 1.32, 95% CI 1.04 to 1.68). Subgroup analyses did not identify any differences by gender.ConclusionsOur findings suggest that deficiencies in social relationships are associated with an increased risk of developing CHD and stroke. Future studies are needed to investigate whether interventions targeting loneliness and social isolation can help to prevent two of the leading causes of death and disability in high-income countries.Study registration numberCRD42014010225. |
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| AbstractList | BackgroundThe influence of social relationships on morbidity is widely accepted, but the size of the risk to cardiovascular health is unclear.ObjectiveWe undertook a systematic review and meta-analysis to investigate the association between loneliness or social isolation and incident coronary heart disease (CHD) and stroke.MethodsSixteen electronic databases were systematically searched for longitudinal studies set in high-income countries and published up until May 2015. Two independent reviewers screened studies for inclusion and extracted data. We assessed quality using a component approach and pooled data for analysis using random effects models.ResultsOf the 35925 records retrieved, 23 papers met inclusion criteria for the narrative review. They reported data from 16 longitudinal datasets, for a total of 4628 CHD and 3002 stroke events recorded over follow-up periods ranging from 3 to 21years. Reports of 11 CHD studies and 8 stroke studies provided data suitable for meta-analysis. Poor social relationships were associated with a 29% increase in risk of incident CHD (pooled relative risk: 1.29, 95% CI 1.04 to 1.59) and a 32% increase in risk of stroke (pooled relative risk: 1.32, 95% CI 1.04 to 1.68). Subgroup analyses did not identify any differences by gender.ConclusionsOur findings suggest that deficiencies in social relationships are associated with an increased risk of developing CHD and stroke. Future studies are needed to investigate whether interventions targeting loneliness and social isolation can help to prevent two of the leading causes of death and disability in high-income countries.Study registration numberCRD42014010225. BackgroundThe influence of social relationships on morbidity is widely accepted, but the size of the risk to cardiovascular health is unclear.ObjectiveWe undertook a systematic review and meta-analysis to investigate the association between loneliness or social isolation and incident coronary heart disease (CHD) and stroke.MethodsSixteen electronic databases were systematically searched for longitudinal studies set in high-income countries and published up until May 2015. Two independent reviewers screened studies for inclusion and extracted data. We assessed quality using a component approach and pooled data for analysis using random effects models.ResultsOf the 35 925 records retrieved, 23 papers met inclusion criteria for the narrative review. They reported data from 16 longitudinal datasets, for a total of 4628 CHD and 3002 stroke events recorded over follow-up periods ranging from 3 to 21 years. Reports of 11 CHD studies and 8 stroke studies provided data suitable for meta-analysis. Poor social relationships were associated with a 29% increase in risk of incident CHD (pooled relative risk: 1.29, 95% CI 1.04 to 1.59) and a 32% increase in risk of stroke (pooled relative risk: 1.32, 95% CI 1.04 to 1.68). Subgroup analyses did not identify any differences by gender.ConclusionsOur findings suggest that deficiencies in social relationships are associated with an increased risk of developing CHD and stroke. Future studies are needed to investigate whether interventions targeting loneliness and social isolation can help to prevent two of the leading causes of death and disability in high-income countries.Study registration numberCRD42014010225. The influence of social relationships on morbidity is widely accepted, but the size of the risk to cardiovascular health is unclear.BACKGROUNDThe influence of social relationships on morbidity is widely accepted, but the size of the risk to cardiovascular health is unclear.We undertook a systematic review and meta-analysis to investigate the association between loneliness or social isolation and incident coronary heart disease (CHD) and stroke.OBJECTIVEWe undertook a systematic review and meta-analysis to investigate the association between loneliness or social isolation and incident coronary heart disease (CHD) and stroke.Sixteen electronic databases were systematically searched for longitudinal studies set in high-income countries and published up until May 2015. Two independent reviewers screened studies for inclusion and extracted data. We assessed quality using a component approach and pooled data for analysis using random effects models.METHODSSixteen electronic databases were systematically searched for longitudinal studies set in high-income countries and published up until May 2015. Two independent reviewers screened studies for inclusion and extracted data. We assessed quality using a component approach and pooled data for analysis using random effects models.Of the 35 925 records retrieved, 23 papers met inclusion criteria for the narrative review. They reported data from 16 longitudinal datasets, for a total of 4628 CHD and 3002 stroke events recorded over follow-up periods ranging from 3 to 21 years. Reports of 11 CHD studies and 8 stroke studies provided data suitable for meta-analysis. Poor social relationships were associated with a 29% increase in risk of incident CHD (pooled relative risk: 1.29, 95% CI 1.04 to 1.59) and a 32% increase in risk of stroke (pooled relative risk: 1.32, 95% CI 1.04 to 1.68). Subgroup analyses did not identify any differences by gender.RESULTSOf the 35 925 records retrieved, 23 papers met inclusion criteria for the narrative review. They reported data from 16 longitudinal datasets, for a total of 4628 CHD and 3002 stroke events recorded over follow-up periods ranging from 3 to 21 years. Reports of 11 CHD studies and 8 stroke studies provided data suitable for meta-analysis. Poor social relationships were associated with a 29% increase in risk of incident CHD (pooled relative risk: 1.29, 95% CI 1.04 to 1.59) and a 32% increase in risk of stroke (pooled relative risk: 1.32, 95% CI 1.04 to 1.68). Subgroup analyses did not identify any differences by gender.Our findings suggest that deficiencies in social relationships are associated with an increased risk of developing CHD and stroke. Future studies are needed to investigate whether interventions targeting loneliness and social isolation can help to prevent two of the leading causes of death and disability in high-income countries.CONCLUSIONSOur findings suggest that deficiencies in social relationships are associated with an increased risk of developing CHD and stroke. Future studies are needed to investigate whether interventions targeting loneliness and social isolation can help to prevent two of the leading causes of death and disability in high-income countries.CRD42014010225.STUDY REGISTRATION NUMBERCRD42014010225. The influence of social relationships on morbidity is widely accepted, but the size of the risk to cardiovascular health is unclear. We undertook a systematic review and meta-analysis to investigate the association between loneliness or social isolation and incident coronary heart disease (CHD) and stroke. Sixteen electronic databases were systematically searched for longitudinal studies set in high-income countries and published up until May 2015. Two independent reviewers screened studies for inclusion and extracted data. We assessed quality using a component approach and pooled data for analysis using random effects models. Of the 35 925 records retrieved, 23 papers met inclusion criteria for the narrative review. They reported data from 16 longitudinal datasets, for a total of 4628 CHD and 3002 stroke events recorded over follow-up periods ranging from 3 to 21 years. Reports of 11 CHD studies and 8 stroke studies provided data suitable for meta-analysis. Poor social relationships were associated with a 29% increase in risk of incident CHD (pooled relative risk: 1.29, 95% CI 1.04 to 1.59) and a 32% increase in risk of stroke (pooled relative risk: 1.32, 95% CI 1.04 to 1.68). Subgroup analyses did not identify any differences by gender. Our findings suggest that deficiencies in social relationships are associated with an increased risk of developing CHD and stroke. Future studies are needed to investigate whether interventions targeting loneliness and social isolation can help to prevent two of the leading causes of death and disability in high-income countries. CRD42014010225. Background The influence of social relationships on morbidity is widely accepted, but the size of the risk to cardiovascular health is unclear. Objective We undertook a systematic review and meta-analysis to investigate the association between loneliness or social isolation and incident coronary heart disease (CHD) and stroke. Methods Sixteen electronic databases were systematically searched for longitudinal studies set in high-income countries and published up until May 2015. Two independent reviewers screened studies for inclusion and extracted data. We assessed quality using a component approach and pooled data for analysis using random effects models. Results Of the 35 925 records retrieved, 23 papers met inclusion criteria for the narrative review. They reported data from 16 longitudinal datasets, for a total of 4628 CHD and 3002 stroke events recorded over follow-up periods ranging from 3 to 21 years. Reports of 11 CHD studies and 8 stroke studies provided data suitable for meta-analysis. Poor social relationships were associated with a 29% increase in risk of incident CHD (pooled relative risk: 1.29, 95% CI 1.04 to 1.59) and a 32% increase in risk of stroke (pooled relative risk: 1.32, 95% CI 1.04 to 1.68). Subgroup analyses did not identify any differences by gender. Conclusions Our findings suggest that deficiencies in social relationships are associated with an increased risk of developing CHD and stroke. Future studies are needed to investigate whether interventions targeting loneliness and social isolation can help to prevent two of the leading causes of death and disability in high-income countries. Study registration number CRD42014010225. |
| Author | Hanratty, Barbara Kanaan, Mona Valtorta, Nicole K Gilbody, Simon Ronzi, Sara |
| AuthorAffiliation | 3 Department of Health Sciences , University of York , Heslington, York , UK 1 Department of Health Sciences , University of York , Heslington, York , UK 5 Institute of Health and Society/Newcastle University Institute for Ageing, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University , Newcastle upon Tyne , UK 4 Department of Public Health and Society , Whelan Building, Brownlow Hill , Liverpool , UK 2 Department of Health Sciences , University of York , Heslington, York , UK |
| AuthorAffiliation_xml | – name: 1 Department of Health Sciences , University of York , Heslington, York , UK – name: 2 Department of Health Sciences , University of York , Heslington, York , UK – name: 3 Department of Health Sciences , University of York , Heslington, York , UK – name: 5 Institute of Health and Society/Newcastle University Institute for Ageing, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University , Newcastle upon Tyne , UK – name: 4 Department of Public Health and Society , Whelan Building, Brownlow Hill , Liverpool , UK |
| Author_xml | – sequence: 1 givenname: Nicole K orcidid: 0000-0002-9694-7965 surname: Valtorta fullname: Valtorta, Nicole K email: nicole.valtorta@york.ac.uk organization: Department of Health Sciences, University of York, Heslington, York, UK – sequence: 2 givenname: Mona surname: Kanaan fullname: Kanaan, Mona email: nicole.valtorta@york.ac.uk organization: Department of Health Sciences, University of York, Heslington, York, UK – sequence: 3 givenname: Simon surname: Gilbody fullname: Gilbody, Simon email: nicole.valtorta@york.ac.uk organization: Department of Health Sciences, University of York, Heslington, York, UK – sequence: 4 givenname: Sara surname: Ronzi fullname: Ronzi, Sara email: nicole.valtorta@york.ac.uk organization: Department of Public Health and Society, Whelan Building, Brownlow Hill, Liverpool, UK – sequence: 5 givenname: Barbara surname: Hanratty fullname: Hanratty, Barbara email: nicole.valtorta@york.ac.uk organization: Institute of Health and Society/Newcastle University Institute for Ageing, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27091846$$D View this record in MEDLINE/PubMed |
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A 15 year follow-up in the study of men born in 1933 publication-title: Eur Heart J doi: 10.1016/j.ehj.2003.10.005 – reference: 27888229 - Heart. 2016 Dec 15;102(24):2016. doi: 10.1136/heartjnl-2016-310073. – reference: 27091845 - Heart. 2016 Jul 1;102(13):987-9. doi: 10.1136/heartjnl-2015-309242. |
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| Snippet | BackgroundThe influence of social relationships on morbidity is widely accepted, but the size of the risk to cardiovascular health is unclear.ObjectiveWe... The influence of social relationships on morbidity is widely accepted, but the size of the risk to cardiovascular health is unclear. We undertook a systematic... Background The influence of social relationships on morbidity is widely accepted, but the size of the risk to cardiovascular health is unclear. Objective We... The influence of social relationships on morbidity is widely accepted, but the size of the risk to cardiovascular health is unclear.BACKGROUNDThe influence of... |
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| SubjectTerms | Bias Cardiac Risk Factors and Prevention Cardiovascular disease Coronary Disease - etiology Coronary Disease - psychology Humans Loneliness Observational Studies as Topic Risk Factors Social Isolation Socioeconomic factors Stroke - etiology Stroke - psychology |
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| Title | Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies |
| URI | https://heart.bmj.com/content/102/13/1009.full https://www.ncbi.nlm.nih.gov/pubmed/27091846 https://www.proquest.com/docview/1801485837 https://www.proquest.com/docview/1795880266 https://www.proquest.com/docview/1808691292 https://pubmed.ncbi.nlm.nih.gov/PMC4941172 |
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