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The relationship between social isolation, social support, and loneliness with cardiovascular disease and shared risk factors: A narrative review

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ELSEVIER IRELAND LTD
DOI: 10.1016/j.archger.2023.105008

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Social support; Social isolation; Loneliness; Cardiovascular disease; Social interaction; Cardiovascular disease risk factors

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Social health is closely related to cardiovascular disease, potentially mediated through its shared risk factors. However, the mechanisms underlying the relationship between social health and cardiovascular disease are poorly understood. Further research is needed to determine whether targeting certain social health constructs may directly improve cardiovascular disease risk factors.
Background: Cardiovascular disease (CVD) is the greatest contributor to global morbidity and mortality. Poor social health plays a critical role in CVD incidence. Additionally, the relationship between social health and CVD may be mediated through CVD risk factors. However, the underlying mechanisms between social health and CVD are poorly understood. Certain social health constructs (social isolation, low social support and loneliness) have complicated the characterisation of a causal relationship between social health and CVD. Aim: To provide an overview of the relationship between social health and CVD (and its shared risk factors).Method: In this narrative review, we examined published literature on the relationship between three social health constructs (social isolation, social support, and loneliness) and CVD. Evidence was synthesised in a narrative format, focusing on the potential ways in which social health affects CVD, including shared risk factors.Results: The current literature highlights an established relationship between social health and CVD with a likelihood for bi-directionality. However, there is speculation and varied evidence regarding how these relationships may be mediated through CVD risk factors.Conclusions: Social health can be considered an established risk factor for CVD. However, the potential bidirectional pathways of social health with CVD risk factors are less established. Further research is needed to understand whether targeting certain constructs of social health may directly improve the management of CVD risk factors. Given the health and economic burdens of poor social health and CVD, improvements to addressing or preventing these interrelated health conditions would have societal benefits.

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