Association of Social Isolation and Loneliness With Incident Heart Failure in a Population-Based Cohort Study

Yannis Yan Liang, Yilin Chen, Hongliang Feng, Xiangxin Liu, Qi Yong H. Ai, Huachen Xue, Xinyue Shu, Foqian Weng, Zhixuan He, Jiacheng Ma, Huan Ma, Sizhi Ai, Qingshan Geng, Jihui Zhang

Research output: Journal article publicationJournal articleAcademic researchpeer-review

18 Citations (Scopus)


Background: Social isolation and loneliness have emerged as important risk factors for cardiovascular diseases, particularly during the coronavirus disease pandemic. However, it is unclear whether social isolation and loneliness had independent and joint associations with incident heart failure (HF). Objectives: This study sought to examine the association of social isolation, loneliness, and their combination with incident HF. Methods: The UK Biobank study is a population-based cohort study. Social isolation and loneliness were assessed using self-reported questionnaires. HF cases were identified by linking hospital records and death registries. The weighted polygenic risk score associated with HF was calculated. Results: Among the 464,773 participants (mean age: 56.5 ± 8.1 years, 45.3% male), 12,898 incident HF cases were documented during a median follow-up of 12.3 years. Social isolation (most vs least: adjusted HR: 1.17; 95% CI:1.11-1.23) and loneliness (yes vs no: adjusted HR: 1.19; 95% CI: 1.11-1.27) were significantly associated with an increased risk of incident HF. The association between an elevated risk of HF and social isolation was modified by loneliness (Pinteraction = 0.034). A gradient of association between social isolation and the risk of incident HF was found only among individuals without loneliness (Ptrend < 0.001), but not among those with loneliness (Ptrend = 0.829). These associations were independent of the genetic risk of HF. Conclusions: Social isolation and loneliness were independently associated with a higher likelihood of incident HF regardless of genetic risk. The association between social isolation and incident HF was potentially modified by loneliness status.

Original languageEnglish
Pages (from-to)334-344
Number of pages11
JournalJACC: Heart Failure
Issue number3
Publication statusPublished - Mar 2023


  • genetic predisposition to disease
  • heart failure
  • loneliness
  • social isolation
  • UK Biobank

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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