Does loneliness increase your risk of heart attack or stroke?
Loneliness has been linked to an increased risk of heart attack or stroke, but does the research stack up? We look behind the headlines.
Your risk of stroke and heart attack could increase if you are lonely, the media have claimed this week.
The research, from the University of York, suggested that loneliness and social isolation are linked to a 29 per cent increased risk of a heart attack or angina and a 32 per cent heightened risk of having a stroke.
This increase is comparable to other recognised psychological risk factors, such as anxiety and a stressful job, the researchers suggest.
What was the research like?
This was a meta-analysis, which is a type of research that looks at existing studies on a topic and analyses the collective data to see what we can learn from them.
A strength of this research was that it analysed longitudinal studies, which collectively covered a large number of people – 181,000 people – for between three and 21 years. Longitudinal studies can be good at establishing relationships, as the same people are observed over a long time period.
Social isolation is a serious issue that affects many thousands of people across the UK
Senior Cardiac Nurse
However, defining loneliness could be problematic. The researchers defined it as “as a subjective negative feeling associated with someone’s perception that their relationships with others are deficient”. But since this is a subjective judgement it depends how the person perceives the situation. The definition of lonely could vary greatly between participants.
The 23 studies that the researchers analysed were a mix of research that measured loneliness (three studies), social isolation (18 studies) and a mix of the two (two studies). Social isolation and loneliness are not quite the same thing. Loneliness is usually defined as feeling unhappy about a situation - a lack of social relationships, or shortcomings in social relationships, while social isolation is the situation itself – having few social contacts.
People were included if they expressed a feeling that their relationships with others "are deficient", which depending on the type of deficiency, might not be what we usually think of as loneliness.
The researchers also recognised that lonely and isolated people are more likely to smoke and be physically inactive, so the increased risk of heart problems could be partly linked to this, rather than loneliness itself.
Another possible weakness is that the studies reviewed included some published outside of the traditional academic process, and they may not have been stringently reviewed for accuracy.
The story was covered by the Guardian, the Mirror, the Independent, and the Daily Mail, amongst others.
Most coverage was quite accurate, although some of the headlines were slightly less so. The Independent’s headline was “Loneliness can trigger heart disease and strokes, new research suggests” The use of the word “trigger” suggests a direct cause and effect, which could not be proved from this type of study.
The BHF view
Christopher Allen, Senior Cardiac Nurse at the British Heart Foundation, said: “Social isolation is a serious issue that affects many thousands of people across the UK. We know that loneliness, and having few social contacts, can lead to poor lifestyle habits such as smoking, which can increase your risk of heart disease and stroke.
Much more research is needed to understand if there truly is a relationship between the two
“Although this observational study suggests a physiological link between loneliness and heart health problems, this is not a clear link, and much more research is needed to understand if there truly is a relationship between the two. Earlier BHF-funded research has shown an association between social isolation and increased risk of dying, and the BHF continues to fund research exploring how our mental health affects our risk of developing heart problems.
“It’s important for anyone affected by loneliness to remember that they can reach out to their GP for help and advice and also take further steps to improve their wellbeing such as joining a local community group or possibly volunteering in their free time.”