Living alone does not appear to worsen heart disease

(Reuters Health) - For people with well-controlled heart disease, living alone isn’t linked with a higher risk of cardiovascular problems, a large study suggests.

For five years, researchers tracked more than 32,000 patients from 45 countries. All were living with stable coronary artery disease, which means the arteries that carry blood to the heart were narrowed or clogged but hadn’t been causing problems for at least several months. About 11 percent of study participants lived alone.

After accounting for factors that might influence the risk of heart problems - such as age, sex, smoking status, and diabetes - the researchers found that overall, compared to participants who lived with other people, those living alone had no higher risk for heart attacks, strokes, heart failure or death.

Researchers did see a difference between men and women, however. Men living alone had a 17 percent higher risk for major adverse cardiovascular events, according to the report in the journal Heart.

“Men living alone who previously were married or cohabited with women may not have as strong coping mechanisms or social supports,” lead author Dr. Sumeet Gandhi of St Michael’s Hospital and the University of Toronto told Reuters Health.

The researchers also highlight some findings that were not statistically significant, meaning they could have been coincidental and need closer study. For instance, women living alone tended to have a lower risk of heart attack compared with women or men living with others.

“Historically, women manage the household and assume a nurturing role and may develop superior self-care skills than their male counterparts,” Gandhi and colleagues write. “Women socialize differently than men and may form stronger social networks . . . relying less on spousal support compared with men.”

Another possibly coincidental finding was that patients age 75 and older who lived alone tended to have lower risks for heart attack and stroke, whereas people under age 65 who lived alone tended to have higher risks.

The authors suggest that younger participants’ social interactions may be more pressured, resulting in poor health behavior, while patients above the age 75 living independently may be relatively healthy.

Previous research has suggested that patients living alone may be at increased risk of cardiovascular events. The new results may be the result of improved healthcare and better follow-up, the authors say.

The study wasn’t designed to prove whether living situations affect the course of heart disease. Furthermore, the researchers lacked information on patients’ economic status, their proximity to support systems and resources, and whether they suffered from depression or stress. Gandhi said further studies are needed to consider these and other important variables.

Having this information “may help guide future potential psychosocial interventions,” he added.

Dr. Gregory Marcus, Director of Clinical Research for the Division of Cardiology at the University of California, San Francisco, who wasn’t involved in the study, commented to Reuters Health that on the one hand, people who live alone are more likely self-sufficient and in relatively good shape. But on the other hand, older people living alone with severe forms of disease will inevitably face problems, with no one to monitor them.

SOURCE: Heart, online February 21, 2019.