Association of social relationships with incident cardiovascular events and all-cause mortality. Issue 17 (12th March 2020)

• Record Type: Journal Article
• Authors: Gronewold, Janine; Kropp, Rene; Lehmann, Nils; Schmidt, Börge; Weyers, Simone; Siegrist, Johanne; Dragano, Nico; Jöckel, Karl-Heinz; Erbel, Raimund; Hermann, Dirk M
• Is Part Of: Heart. Volume 106:Issue 17(2020)
• Page Start: 1317
• Page End: 1323
• Publication Date: 2020-03-12
• Subjects: epidemiology -- stroke -- cardiac risk factors and prevention; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2019-316250
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objective: To examine how different aspects of social relationships are associated with incident cardiovascular events and all-cause mortality. Methods: In 4139 participants from the population-based Heinz Nixdorf Recall study without previous cardiovascular disease (mean (SD) age 59.1 (7.7) years, 46.7% men), the association of self-reported instrumental, emotional and financial support and social integration at baseline with incident fatal and non-fatal cardiovascular events and all-cause mortality during 13.4-year follow-up was assessed in five different multivariable Cox proportional hazards regression models: minimally adjusted model (adjusting for age, sex, social integration or social support, respectively); biological model (minimally adjusted+systolic blood pressure, low-density and high-density lipoprotein cholesterol, glycated haemoglobin, body mass index, antihypertensive medication, lipid-lowering medication and antidiabetic medication); health behaviour model (minimally adjusted+alcohol consumption, smoking and physical activity); socioeconomic model (minimally adjusted+income, education and employment); and depression model (minimally adjusted+depression, antidepressants and anxiolytics). Results: 339 cardiovascular events and 530 deaths occurred during follow-up. Lack of financial support was associated with an increased cardiovascular event risk (minimally adjusted HR=1.30(95% CI 1.01 to 1.67)). Lack of social integration (social isolation) was associated with increased mortality (minimally adjusted HR=1.47 (95% CI 1.09 to 1.97)). Effect estimates did not decrease to a relevant extent in any regression model. Conclusions: Perceiving a lack of financial support is associated with a higher cardiovascular event incidence, and being socially isolated is associated with increased all-cause mortality. Future studies should investigate how persons with deficient social relationships could benefit from targeted interventions.