Abstract | OBJECTIVE: To examine how different aspects of social relationships are associated with incident cardiovascular events and all-cause mortality. METHODS: In 4139 participants from the population-based Heinz Nixdorf Recall study without previous cardiovascular disease (mean (SD) age 59.1 (7.7) years, 46.7% men), the association of self-reported instrumental, emotional and financial support and social integration at baseline with incident fatal and non-fatal cardiovascular events and all-cause mortality during 13.4-year follow-up was assessed in five different multivariable Cox proportional hazards regression models: minimally adjusted model (adjusting for age, sex, social integration or social support, respectively); biological model (minimally adjusted+systolic blood pressure, low-density and high-density lipoprotein cholesterol, glycated haemoglobin, body mass index, antihypertensive medication, lipid-lowering medication and antidiabetic medication); health behaviour model (minimally adjusted+alcohol consumption, smoking and physical activity); socioeconomic model (minimally adjusted+income, education and employment); and depression model (minimally adjusted+depression, antidepressants and anxiolytics). RESULTS: 339 cardiovascular events and 530 deaths occurred during follow-up. Lack of financial support was associated with an increased cardiovascular event risk (minimally adjusted HR=1.30(95% CI 1.01 to 1.67)). Lack of social integration (social isolation) was associated with increased mortality (minimally adjusted HR=1.47 (95% CI 1.09 to 1.97)). Effect estimates did not decrease to a relevant extent in any regression model. CONCLUSIONS: Perceiving a lack of financial support is associated with a higher cardiovascular event incidence, and being socially isolated is associated with increased all-cause mortality. Future studies should investigate how persons with deficient social relationships could benefit from targeted interventions.
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Authors | Janine Gronewold, Rene Kropp, Nils Lehmann, Börge Schmidt, Simone Weyers, Johanne Siegrist, Nico Dragano, Karl-Heinz Jöckel, Raimund Erbel, Dirk M Hermann, Heinz Nixdorf Recall Study Investigative Group |
Journal | Heart (British Cardiac Society)
(Heart)
Vol. 106
Issue 17
Pg. 1317-1323
(09 2020)
ISSN: 1468-201X [Electronic] England |
PMID | 32165451
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. |
Topics |
- Aged
- Cardiovascular Diseases
(diagnosis, mortality, psychology)
- Female
- Financial Support
- Germany
(epidemiology)
- Heart Disease Risk Factors
- Humans
- Incidence
- Interpersonal Relations
- Male
- Middle Aged
- Prognosis
- Risk Assessment
- Social Behavior
- Social Determinants of Health
- Social Integration
- Social Isolation
- Social Support
- Time Factors
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