Loneliness, social isolation and cardiovascular disease risk in patients over forty-five years old (review)

Among the important psychosocial risk factors (RFs) for cardiovascular disease (CVD), loneliness and social isolation hold a special place. The prevalence of these RFs is increasing among people of all ages due to social, cognitive, and behavioral factors. However, in clinical practice, there is a lack of a thorough understanding of the distinctive characteristics of loneliness and social isolation, their causes, and their negative consequences for the development of CVDs, such as hypertension, atherosclerosis, and many others, including endothelial dysfunction.

Loneliness and social isolation are associated with a higher risk of CVD regardless of sex, as confirmed by various meta-analyses. There are conflicting data regarding the impact on mortality. Some national cohorts have shown an increased risk of cardiovascular mortality in conditions of loneliness, while in others this relationship has not been confirmed due to cultural differences. Social isolation increases the risk of death from coronary heart disease and stroke indirectly through sympathetic nervous system activation, chronic inflammation, and unhealthy behaviour (smoking, sedentary lifestyle and poor diet).

Loneliness and social isolation are significant underlying psychosocial risk factors, requiring regular screening using validated scales.

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