The Stroke Threat You’ve Never Heard Of
Regardless of their personal habits, most Americans know that diet, exercise, sleep, and other lifestyle measures can affect their risk of developing heart disease and experiencing a life-changing stroke. But another, less obvious factor appears to play a role in these common heart problems: Sheer loneliness.
The link was confirmed in a recent review study from the University of York in the United Kingdom, where researchers pooled the results of 23 separate studies involving 180,000 people who had been followed for periods ranging from three to 21 years. All other things being equal, they showed, people who were socially isolated had a 32 percent increase in the risk of stroke—the fourth leading cause of death and the main cause of disability in the U.S. Those with poor social connections faced a 29 percent increased risk of heart disease overall.
Compared to other risk factors for stroke, loneliness and social isolation were pretty significant. They had an effect equal to work stress on stroke risk. And a lack of connectedness was similar in impact to anxiety in predicting who will develop heart disease.
These findings aren’t entirely new, though the study itself is robust. Previous research has found that social isolation not only boosts the risk for stroke but also impedes a patient’s recovery after experiencing a stroke and increases the risk that death will follow the event. And numerous studies have found a causal association between social relationships and mortality due to a variety of causes. Humans clearly require social connections to enjoy optimal health and well being.
Scientists are also closing in on how these effects occur. For instance, people who are alone may be less likely to take medications prescribed to prevent stroke and other heart-related medical problems or engage in healthy behaviors that protect the cardiovascular system, such as eating a heart-healthy diet.
The stress that isolation triggers may raise blood pressure or inflammation in the body, thus increasing the risk for heart events. In fact previous research shows a connection between social factors and blood pressure and inflammatory markers like C-reactive protein, with people who are less connected having higher blood pressure readings and blood levels of the inflammation signaler.
What’s more, stress and loneliness seem to act synergistically to promote inflammation associated with heart disease. Data shows that the inflammatory markers fibrinogen and C-reactive protein have a particularly strong association with social isolation.
Given the exploding population of older adults, many who will undoubtedly be living out their later years alone, this body of research doesn’t bode well for future stroke and heart disease trends. Yet there are many ways to promote seniors’ ability to connect or put them in contact with others, such as behavioral therapy or activity programs common at community centers and places of worship. People can also be encouraged to volunteer at social events.
Providers first need to know whether their patients are lonely and if there are elevations in inflammatory biomarkers which may mean they are at increased heart attack or stroke risk. If abnormalities are discovered, it is important to let patients know the resources available for them. The right intervention could result in both happier—and healthier—patients.