Psycho-social dimensions of cardiovascular risk: exploring the impact of social isolation and loneliness in middle-aged and older adults

Abstract Background Cardiovascular disease (CVD) is a major health concern for middle-aged and older adults, with lifestyle and metabolic risk factors well-studied. However, the role of psychosocial factors in CVD remains underexplored. Objective This study aims to delve into the connection between psychosocial factors and the occurrence of CVD. Methods We utilized data from the UK Biobank, a large-scale study covering adults aged 38 to 73 recruited from various centers across the UK between 2006 and 2010. We employed Cox proportional hazards models to analyze the relationship between social isolation, loneliness, and incident CVD. CVD diagnoses were confirmed through hospital records and death-register data. Additionally, we conducted mediation analyses to assess the impact of low-grade inflammation. Results The study encompassed 427,942 participants free from CVD, 55.8% of whom are women. High levels of social isolation and loneliness were linked to a higher risk of CVD (HRs 1.11, 95% CI 1.06–1.16; HRs 1.17, 95% CI 1.11–1.23). Depression also emerged as a predictor of CVD onset (HRs 1.25, 95% CI 1.19–1.31), with each psychosocial factor independently contributing to increased CVD risk. Mediation analyses pinpointed inflammation as a crucial mediator, especially for loneliness (indirect effect proportion: 4.7%). Conclusions This study underscores the significance of psychosocial factors in relation to CVD. Integrating assessments for social isolation, loneliness, and depression into routine healthcare could potentially aid in CVD prevention among middle-aged and elderly individuals. Lay summary This study underscores the significance of psychosocial factors in relation to CVD, emphasizing the association between social isolation or loneliness and the heightened risk of CVD. Graphical abstract