Lonely people are twice as likely to die from heart problems

We live in an era characterised by social media and are connected via technology like never before. Yet people are feeling lonelier than ever before. A study conducted in Denmark investigated whether poor social network was associated with worse outcomes in 13,463 patients with heart disease, arrhythmia (abnormal heart rhythm), heart failure, or heart valve disease. Feeling lonely was associated with poor outcomes in all patients regardless of their type of heart disease, and even after adjusting for factors like age, level of education, other diseases, body mass index, smoking and alcohol intake. Loneliness was associated with a doubled mortality risk in women and nearly doubled risk in men. Both men and women who felt lonely were three times more likely to report symptoms of anxiety and depression, and had a significantly lower quality of life than those who did not feel lonely.

Can loneliness trigger cardiovascular issues?

Mansi Hasan, clinical psychologist and psychotherapist, tobacco treatment specialist, opines that loneliness can trigger cardiovascular issues. “Social isolation caused by loneliness leads to an unhealthy lifestyle. People who feel lonely are likely to compensate the ‘void’ by several negative coping mechanisms such as unhealthy eating habits, erratic sleep patterns, smoking, excessive drinking, etc. These factors often are the cause of making individuals who are lonely more prone to heart-related diseases. Lonely people don’t have an emotional outlet, which leads to increased stress levels. Pent-up emotions are a big cause of psychosomatic disorders,” she explains.

Dr Santosh Kumar Dora, senior cardiac electro physiologist, Asian Heart Institute, too, agrees to the finding that loneliness increases the risk of death. He says, “A meta-analysis by Dr Nicole Valtorta published in journal Heart in 2016, had shown that there is a 29 per cent risk of coronary artery disease and 32 per cent risk of stroke in patients living in loneliness and social isolation in the developed countries. However, in this study after adjusting these factors also it was seen that loneliness can double the risk of death.”

Less prevalent in India

Loneliness among the elderly is a major problem in the West. Fortunately, in India, the social bonding is stronger and family more often lives together and takes care of elderly people in the family, informs Dr Dora. “However, we sometimes come across people living alone when their children are settled abroad. These patients are very prone to unhealthy lifestyle and drug non-compliance. So, we advise them to mix with others, join social groups, engage on social network platform, do charitable works etc. This keeps them engaged and gives opportunity to mix with others and avoid loneliness,” he adds.

Though Hasan says it’s less prevalent in our society, she adds, “Being 15 years in the practice, I see people with such concerns more in the recent times. I would say three out of five people dealing with loneliness are prone to cardiovascular issues. The age group would largely lie among people who are single and elderly.” She has dealt with patients with cardiovascular issues and the reason for them to be referred is more often due to depression, anxiety, alcohol dependence, smoking, drug dependence. She sees at least four to five such people every month, their concern to meet their physician is their physical health but the cause of it is their mental health. The age group is mainly between 40-50 years and also 60-65 years they are mostly people are single, separated or elderly.

Scepticism

Dr Bipeenchandra Bhamre, cardio-thoracic surgeon, Sir H N Reliance Foundation Hospital and Research Centre, says that cardiovascular disease and dying from heart attack is multifactorial. Factors like age, gender, issues like hypertension, diabetes, cholesterol, smoking, alcohol, lack of exercise, socio-economic factors and genetics, all matter. He adds, “I do not agree completely with these studies as such factors are not taken into consideration. We need to evaluate further by matching the married and unmarried population with the risk factors. Further randomised studies are required to evaluate the said association between marriage and heart disease. Unmarried does not mean lonely, you can be unmarried and socially active. It’s complex. There are so many things that have not matched to the population.”

Dr Bhamre further adds, “Rather than loneliness, it’s one’s lifestyle that is more important. It matters more if one doesn’t have risk factors like hypertension, diabetes or high cholesterol, and one exercises regularly and doesn’t smoke rather than loneliness. It’s chronic stress that matters more. But it’s not necessary that chronic stress is because one is unmarried, it could be any problem. In our practice, we see more married men and women undergoing bypass than unmarried men and women.”