Living alone puts people with heart problems at risk for death

BOSTON, MA—According to the United States Census Bureau, approximately one in seven American adults live alone. Social isolation and lack of social support have been linked to poor health outcomes. Now a new study at Brigham and Women's Hospital (BWH) shows that living alone may be a risk factor for death, especially death due to cardiovascular problems, such as heart attack and stroke.

The study is the first to prospectively compare the cardiovascular risk of living alone in an international outpatient population. It will be published online in Archives of Internal Medicine on June 18, 2012.

Jacob A. Udell MD

Researchers analyzed data from 44,573 participants in the international Reduction of Atherothrombosis for Continued Health (REACH) Registry. Participants at risk for or with atherosclerosis (hardening of blood vessels) were followed for up to four years for cardiovascular events.

Of the 44,573 participants, 19 percent (8,594) lived alone. The researchers found that those with atherosclerosis who lived alone had a higher rate of death over four years compared to those who did not live alone, 14.1 percent vs. 11.1 percent, respectively. Death specifically caused by cardiovascular problems was also higher among those living alone, 8.6 percent vs. 6.8 percent, respectively.

Moreover, a person's age influenced mortality risk among those living alone. When looking at participants 45 to 80 years old, those living alone had higher mortality and risk of cardiovascular death compared to those who did not live alone. However, after age 80, living arrangement did not appear to play a role in mortality risk.

"Living alone may be a marker of a stressful situation, such as social isolation due to work or personal reasons, which can influence biological effects on the cardiovascular system," said Jacob Udell, MD, Cardiovascular Division, BWH Department of Medicine, and lead study investigator. "Also, patients who live alone may delay seeking medical attention for concerning symptoms, which can increase their risk of dying from a heart attack or stroke."

The study serves to encourage doctors to ask patients with cardiovascular disease if they live alone. It also emphasizes the need for people to seek immediate medical attention for concerning symptoms.

This research was supported by Sanofi Aventis, Bristol-Myers Squibb, Waksman Foundation (Tokyo, Japan), Canadian Institutes for Health Research, and Canadian Foundation for Women's Health.