Research Highlights:

  • Social isolation and loneliness were each associated with a higher risk for cardiovascular disease in post-menopausal women.
  • The risk of cardiovascular disease events in the women increased 29% when the effect of social isolation and loneliness were combined.
  • Researchers suggest assessing social isolation and loneliness, even with a brief questionnaire, should be incorporated into standard care practice.

Embargoed until 10 a.m. CT/ 11 a.m. ET, Thursday, May 20, 2021

DALLAS, May 20, 2021 — Social isolation and loneliness were each associated with a higher risk for cardiovascular disease in post-menopausal women, according to preliminary research to be presented at the American Heart Association’s Epidemiology, Prevention, Lifestyle & Cardiometabolic Health Conference 2021. The meeting is virtual, May 20-21 and offers the latest science on population-based health and wellness and implications for lifestyle.

Social isolation is the quantifiable measure of social interactions in relationships. Loneliness is the perceived level or feelings of being socially isolated and reflects a feeling of isolation, lack of companionship and feeling left out.

“Cardiovascular disease is the leading cause of death in women in the U.S. We are learning that factors currently not identified in standard care, such as social isolation and loneliness, can impact women’s risk of cardiovascular disease,” said lead study author Natalie Golaszewski, Ph.D., postdoctoral fellow at the Herbert Wertheim School of Public Health and Human Longevity Science at University of California San Diego.

“We are social beings. In this time of COVID-19, so many people are experiencing social isolation and loneliness, which may spiral into chronic states of social isolation and loneliness. It is important to further understand the acute and long-term effects these experiences have on cardiovascular health and overall well-being.”

The researchers examined data from the Women’s Health Initiative Observational Study, a large, multi-center study of women across the U.S. Nearly 60,000 women with no prior history of cardiovascular events (age 73 to 85) self-reported social activities, living alone, marital status, loneliness and social support from 2011-2015 and were followed for up to 4 years for heart attack, stroke and cardiovascular death. The study evaluated the possible links between social isolation and loneliness and the women’s risk of cardiovascular disease events.

To measure loneliness, researchers used a validated scale (the 3-Item UCLA Loneliness Scale). Social Isolation was measured by an index score derived from these questions: whether you are married or in an intimate relationship, whether you live alone and the frequency of social activities — being with friends or family, communicating with friends or family, attending church, going to cultural events, eating out or shopping.

Over the four-year follow-up period, 1,599 heart attacks, strokes or cardiovascular deaths occurred. Researchers found the risk of cardiovascular disease events in the women were:

  • 16% higher in those who experienced high levels of socially isolation;
  • 11% higher in those who experienced high levels of loneliness; and
  • 29% higher in those with both high levels of social isolation and loneliness.

After researchers factored in smoking, physical activity, diet, history of diabetes, high blood pressure, medication use and physical functioning, the links to loneliness and social isolation were decreased. “People who experience social isolation or loneliness tend to withdraw and don’t engage often in healthy behaviors, which may become a cyclical pattern. Over time, the unhealthy behaviors coupled with social isolation and feeling lonely put them at an increased risk for cardiovascular disease,” Golaszewski said.

The researchers recommend future studies should explore ways to address women’s needs for social connection. Some women experience loneliness after being diagnosed with a serious illness and others after the loss of a child, spouse or family member/loved one.

“Our results suggest measures of social isolation and loneliness, even with brief questions, should be incorporated into standard care,” Golaszewski said. “We monitor our patients’ blood pressure, weight and temperature, and it might also be beneficial to capture the social needs that women may be lacking — to better understand cardiovascular risk and develop solutions.”

Co-authors are Andrea Z. LaCroix, Ph.D.; Michael J. LaMonte, Ph.D., M.P.H.; and John Bellettiere, Ph.D., M.P.H Author disclosures are in the abstract.

The study was funded by the National Institute of Aging of the National Institutes of Health.

Additional Resources:

Statements and conclusions of studies that are presented at the American Heart Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers are available here, and the Association’s overall financial information is available here.

The American Heart Association’s EPI | LIFESTYLE 2021 Scientific Sessions is the world’s premier meeting dedicated to the latest advances in population-based science. The virtual meeting will be held Thursday and Friday, May 20–21, 2021. The primary goal of the meeting is to promote the development and application of translational and population science to prevent heart disease and stroke and foster cardiovascular health. The sessions focus on risk factors, obesity, nutrition, physical activity, genetics, metabolism, biomarkers, subclinical disease, clinical disease, healthy populations, global health, and prevention-oriented clinical trials. The Councils on Epidemiology and Prevention and Lifestyle and Cardiometabolic Health (Lifestyle) jointly planned the EPI/Lifestyle 2021 Scientific Sessions. Follow the conference on Twitter at #EPILifestyle21.

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