Social Isolation and Mortality in Ischemic Heart Disease

A 10-Year Follow-up Study of 150 Middle-aged Men

Authors

  • KRISTINA ORTH-GOMÉR,

    Corresponding author
    1. National Institute for Psychosocial Factors and Health and the Karolinska Institute, Stockholm, Sweden
      National Institute for Psychosocial Factors and Health, Box 60210, S-10401 Stockholm, Sweden.
    Search for more papers by this author
  • ANNA-LENA UNDÉN,

    1. National Institute for Psychosocial Factors and Health and the Karolinska Institute, Stockholm, Sweden
    Search for more papers by this author
  • MARY-ELLEN EDWARDS

    1. National Institute for Psychosocial Factors and Health and the Karolinska Institute, Stockholm, Sweden
    Search for more papers by this author

National Institute for Psychosocial Factors and Health, Box 60210, S-10401 Stockholm, Sweden.

Abstract

ABSTRACT The effects of psychosocial and clinical factors on mortality in ischemic heart disease (IHD) were examined in a 10-year follow-up of 150 middle-aged men. Three groups of men were included: men with clinically manifest IHD, men with risk factors and healthy men. Psychosocial factors were assessed by means of standardized questionnaires. They comprised educational level, social class, marital status and a comprehensive assessment of the daily rounds of life of these men. Furthermore, a subjective rating of the own general health status was obtained. The clinical investigation included a standard physical examination, fasting serum lipids, glucose and urate, a frontal and sagittal chest X-ray and a 24-hour ambulatory ECG monitoring. During follow-up 37 men died, 20 of them from IHD. Non-survivors were descriminated from survivors by the following factors: older age, lower education, lower social class, higher systolic blood pressure, increased ventricular irritability and cardiac enlargement. Furthermore, a relative social isolation as indicated by a low social activity level and a poor self-rated general health status was characteristic of non-survivors. In multivariate analyses three factors emerged as the equally strong predictors of mortality, both from all causes and from IHD: social isolation, a poor self-rated health status and ventricular irritability. The psychosocial mortality predictors were independent of and of similar strength as the clinical predictors.

Ancillary