Loneliness and social isolation increase risk of heart attack and stroke

Loneliness and social isolation increase the risk of heart attack and stroke, as well as reduce the prognosis and increase the chances of death from these emergencies, according to a position from the American Cardiology Association (AHA). , American Heart Association) published this Thursday (4).

Coordinated by Professor Crystal Wiley Cené, from the University of California, the document was created by researchers from the United States, France and Germany and synthesizes the existing literature on the subject in four large databases.

Among the research cited in the positioning, a study by the University of York, in the United Kingdom, stands out, which found a 32% increase in the risk of stroke and a 29% increase in the development of coronary artery disease among those with insufficient social connections.

According to the AHA, having infrequent contact with others (social isolation) or having a perception of isolation (loneliness) affects behavioral, psychological and physiological mediators, which in turn can impact heart and brain health.

Aspects such as diet, alcohol consumption, sleep and physical activity are among those that can be altered and lead to more serious consequences.

“Both situations, social isolation and loneliness, can lead to loss of care and harmful behaviors, such as smoking, binge eating and malnutrition”, says doctor Bruno Valdigem, a member of the SBC (Brazilian Society of Cardiology).

A fragile network of relationships is also related to a generalized inflammation process that affects the inner part of blood vessels, impairing their functioning and increasing the risk of cardiovascular problems.

“The inner part of the arteries controls our pressure, releases some substances for the blood not to clot, acts in the relaxation of the brain part, so it has a very important role. accumulate fat, and when the fat plate breaks, there is clotting, thrombosis, heart attack and stroke”, explains the cardiologist.

According to the AHA, both aspects also alter the prognosis of those who have already suffered from cardiac and neurological problems. Neurologist Marcos Christiano Lange, coordinator of the Scientific Department of Cerebrovascular Diseases, Interventional Neurology and Intensive Care in Neurology at ABNeuro (Brazilian Academy of Neurology), explains that this can occur due to the emotional condition that often accompanies the lonely. When a person feels isolated from social life, the probability of wanting to improve may be lower.

In addition, there may be a weaker relationship between these people and the support network. “One of the important points of this document is to draw attention to the need to, in the consultation, examine the physical part and sit down with the patient to understand which network will protect him in case he has chest pain again, has a stroke of Who will he call? The risk of a complication in case of isolation is much higher. The biggest warning in the document is this: patients who have already had a cardiac or cerebral event need to have a very well designed protection and support network “, says Valdigem.

Another point of the document, this one with little evidence, is the association between loneliness and social isolation and dementia and cognitive impairment. “The person who feels alone is usually more introverted and has more difficulty interacting with others. This limits, in the course of his life, the cognitive stimulation, important to avoid and delay the development of some dementias and cognitive loss. participate in a group activity, for example, you enrich yourself much more from a cognitive point of view than when you sit and study alone”, comments Lange.

The researchers also point out that social isolation in children is associated with cardiovascular risk factors, an issue that is already beginning to emerge in clinics. “In my college days, heart disease in children was basically congenital disease. Now it is much more frequent to find children with metabolic syndrome. Today, children of all age groups are becoming less healthy”, says the cardiologist.

For doctors, by focusing on the impact of relationships and loneliness, the document brings important evidence on a subject that is still little addressed in medicine and takes a step forward in the movement of presenting health not as the absence of disease, but as well-being. be.

On the other hand, they remember that there is still a lot to be researched and for the subject to be addressed in consultations, there needs to be time. In a hasty meeting, there is no bonding or the possibility of understanding how the patient feels in relation to social life.