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Can loneliness contribute to heart disease?

study published Tuesday in the journal Heart suggests a link.

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The new research pulled together 23 studies involving more than 181,000 adults in several high-income nations. Analysis of the pooled data found that social isolation was associated with a 29 percent increased risk of a coronary heart disease and a 32 percent higher risk of stroke.

The study does have limitations, said coauthor Nicole Valtorta, a research fellow at the University of York. While loneliness is associated with high risk of heart disease, that doesn’t mean it causes the illness; instead, some third factor might contribute to both. 

Still, an editorial accompanying the study suggests that social isolation should be listed among major risk factors for heart attack or stroke. In addition, the reviewers suggest that government and health advocacy groups establish recommendations for what constitutes healthy social relationships.

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“We have robust evidence” that isolation does increase risk, said Julianne Holt-Lunstad, a Brigham Young University psychology professor and a coauthor of the editorial. She pointed to her own previous studies, involving over 3 million participants, with similar findings.

Valtorta said she and other researchers can now move on to new questions. Among them: Can medical professionals treat patients by helping them form new social connections after years of loneliness?

“We don’t know whether intervening makes a difference in health,” she said. “It could be that the damage is already done, in which case the focus might have to be on prevention.”