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Women, Loneliness, and Incident Coronary Heart Disease
Open accessAbstract
OBJECTIVE: To examine associations between loneliness and risk of incident coronary heart disease (CHD) over a 19-year follow-up period in a community sample of men and women. Loneliness, the perceived discrepancy between actual and desired social relationships, has been linked to several adverse health outcomes. However, no previous research has prospectively examined the association between loneliness and incident CHD in a community sample of men and women. METHODS: Hypotheses were examined using data from the First National Health and Nutrition Survey and its follow-up studies (n = 3003). Loneliness, assessed by one item from the Center for Epidemiologic Studies of Depression scale, and covariates were derived from baseline interviews. Incident CHD was derived from hospital records/death certificates over 19 years of follow-up. Hypotheses were evaluated, using Cox proportional hazards models. RESULTS: Among women, high loneliness was associated with increased risk of incident CHD (high: hazard ratio = 1.76, 95% Confidence Interval = 1.17-2.63; medium: hazard ratio = 0.98, 95% Confidence Interval = 0.64-1.49; reference: low), controlling for age, race, education, income, marital status, hypertension, diabetes, cholesterol, physical activity, smoking, alcohol use, systolic and diastolic blood pressures, and body mass index. Findings persisted additionally controlling for depressive symptoms. No significant associations were observed among men. CONCLUSIONS: Loneliness was prospectively associated with increased risk of incident CHD, controlling for multiple confounding factors. Loneliness among women may merit clinical attention, not only due to its impact on quality of life but also its potential implications for cardiovascular health.
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Among women in the National Health and Nutrition Survey, chronic high frequency loneliness (>3 days/week at each of two measurement occasions about 8 years apart) was prospectively associated with incident coronary heart disease over a 19-year follow-up in analyses adjusted for age, race, socioeconomic status, marital status, and cardiovascular risk factors.
“Among women in the National Health and Nutrition Survey, chronic high frequency loneliness (>3 days/week at each of two measurement occasions about 8 years apart) was prospectively associated with incident coronary heart disease (CHD) over a 19-year follow-up in analyses that adjusted for age, race, socioeconomic status, marital status, and cardiovascular risk factors [19].”
From Loneliness matters: a theoretical and empirical review of consequences and mechanisms (2010) · cites this paper as [19]
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Experimental — accuracy not yet measuredLoneliness continued to predict coronary heart disease in women after also controlling for depressive symptoms.
“Depressive symptoms have been associated with loneliness and with adverse health outcomes, but loneliness continued to predict CHD in these women after also controlling for depressive symptoms.”
From Loneliness matters: a theoretical and empirical review of consequences and mechanisms (2010) · cites this paper as [19]
Loneliness predicts increased morbidity and mortality in longitudinal research.
“A growing body of longitudinal research indicates that loneliness predicts increased morbidity and mortality [12–19].”
From Loneliness matters: a theoretical and empirical review of consequences and mechanisms (2010) · cites this paper as [19]
The association between loneliness and cardiovascular disease and mortality may have its roots in physiological changes that begin early in life.
“The association between loneliness and cardiovascular disease and mortality [13, 14, 19] may have its roots in physiological changes that begin early in life.”
From Loneliness matters: a theoretical and empirical review of consequences and mechanisms (2010) · cites this paper as [19]
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Metadata
- Authors
- Thurston, R. C., & Kubzansky, L. D.
- Affiliations
- Harvard University (US)
- Corresponding author
- Thurston, Rebecca C.
- Venue
- Psychosomatic Medicine
- Published
- 2009-10
- Volume
- 71
- Issue
- 8
- Pages
- 836-842
- ISSN
- 0033-3174 (ISSN-L)
- PMC
- PMC2851545
- OpenAlex
- W2065551728
- Cited by
- 323
- References
- 14
- Citations by year
- 2026: 7 · 2025: 20 · 2024: 21 · 2023: 24 · 2022: 23 · 2021: 29 · 2020: 33 · 2019: 25 · 2018: 26 · 2017: 21 · 2016: 15 · 2015: 21 · 2014: 17 · 2013: 10 · 2012: 13
- FWCI
- 10.22
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (K23AG029216)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- loneliness, coronary artery disease, incident cardiovascular disease, sex differences, women's health, interpersonal relationships, depressive symptoms, cardiovascular risk
- MeSH terms
- Adult, Aged, Cardiovascular Diseases, Coronary Disease, Depression, Female, Follow-Up Studies, Health Status, Health Surveys, Humans, Loneliness, Longitudinal Studies, Middle Aged, Surveys and Questionnaires, Risk Factors, Women, Body Mass Index, Women's Health, Marital Status
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