Behavioural Science and Health, University College London, London, UK.
Epidemiology and Public Health, University College London, London, UK.
Heart. 2020 Sep;106(18):1394-1399. doi: 10.1136/heartjnl-2020-316614. Epub 2020 May 27.
This study aimed to examine the association between loneliness, social isolation and cardiovascular disease (CVD), looking at both self-reported CVD diagnosis and CVD-related hospital admissions.
Data were derived from the English Longitudinal Study of Ageing linked with administrative hospital records and mortality registry data. The analytical sample size was 5850 for the analysis of self-reported CVD and 4587 of CVD derived from hospital records, with a follow-up up to 9.6 years. Data were analysed using survival analysis, accounting for competing risks events.
The mean age was 64 years (SD 8.3). About 44%-45% were men. Within the follow-up, 17% participants reported having newly diagnosed CVD and 16% had a CVD-related hospital admission. We found that loneliness was associated with an increased risk of CVD events independent of potential confounders and risk factors. The hazard of people with the highest level of loneliness was about 30% higher for onset CVD diagnosis (HR: 1.05, 95% CI: 1.01 to 1.09) and 48% higher for CVD-related hospital admissions (HR: 1.08, 95% CI: 1.03 to 1.14), compared with the least lonely. There was little evidence that social isolation was independently associated with the risk of either CVD diagnosis or admission.
Our findings provided strong evidence for the relationship between loneliness and cardiovascular events. Loneliness should be considered as a psychosocial risk factor for CVD in both research and interventions for cardiovascular prevention.
本研究旨在探讨孤独感和社会隔离与心血管疾病(CVD)之间的关联,同时考虑自我报告的 CVD 诊断和与 CVD 相关的住院情况。
数据来自英国老龄化纵向研究,与行政医院记录和死亡率登记数据相关联。分析的样本量为自我报告 CVD 分析的 5850 例和从医院记录中得出的 CVD 分析的 4587 例,随访时间长达 9.6 年。使用生存分析,同时考虑竞争风险事件,对数据进行分析。
平均年龄为 64 岁(标准差 8.3)。约 44%-45%为男性。在随访期间,17%的参与者报告新诊断患有 CVD,16%有与 CVD 相关的住院记录。我们发现,孤独感与 CVD 事件的风险增加独立于潜在的混杂因素和危险因素有关。孤独感最高水平的人发生 CVD 诊断的风险约高 30%(风险比:1.05,95%置信区间:1.01 至 1.09),与 CVD 相关的住院风险高 48%(风险比:1.08,95%置信区间:1.03 至 1.14),与孤独感最低的人相比。几乎没有证据表明社会隔离与 CVD 诊断或入院的风险有独立关联。
我们的研究结果为孤独感与心血管事件之间的关系提供了有力的证据。在研究和心血管预防干预措施中,应将孤独感视为 CVD 的一种心理社会风险因素。