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Table 2 Social health as a predictor of incident and fatal cardiovascular diseasea over 5 years for older adults recruited between 2010 and 2014 in Australia, n = 11,486

From: Social isolation, social support and loneliness as predictors of cardiovascular disease incidence and mortality

End point Social isolation Social support
  Not
(n = 11,262)
Isolated
(n= 224)
Hazard Ratioh p–value 95 % Confidence Interval High
(n = 11,258)
Low
(n = 228)
Hazard Ratioh p–value 95 % Confidence Interval
  events rate events rate events rate events rate
Cardiovascular diseaseb 470 41.7 17 75.9 1.66 0.04 1.02 2.70 467 41.5 20 87.7 2.05 0.002 1.31 3.21
Fatal cardiovascular diseasec 82 7.3 1 4.5 n < 5 81 7.2 2 8.8 n < 5
Major adverse cardiovascular eventd 360 32.0 10 44.6 1.21 0.6 0.64 2.27 356 31.6 14 61.4 1.79 0.03 1.05 3.07
Hozpitalization for heart failuree 94 8.3 5 22.3 2.58 0.04 1.04 6.39 96 8.5 3 13.2 n < 5
Fatal or nonfatal myocardial infarctionf 201 17.8 6 26.8 1.24 0.6 0.55 2.81 202 17.9 5 21.9 1.09 0.9 0.45 2.65
Fatal or nonfatal ischemic strokeg 189 16.8 9 40.2 2.34 0.01 1.19 4.59 186 16.5 12 52.6 3.16 <0.001 1.76 5.68
End point Loneliness Social Health compositei
  Not
(n = 10,927)
Lonely
(n = 559)
Hazard Ratioh p–value 95 % Confidence Interval Poor
(n = 910)
Positive
(n = 10,576)
Hazard Ratioh p–value 95 % Confidence Interval
  events rate events rate events rate events rate
Cardiovascular diseaseb 454 41.5 33 59.0 1.4 0.10 0.95 1.93 56 61.5 431 40.8 1.42 0.01 1.07 1.88
Fatal cardiovascular diseasec 72 6.6 11 19.7 2.55 0.004 1.34 4.83 14 15.4 69 6.5 2.00 0.02 1.12 3.60
Major adverse cardiovascular eventd 343 31.4 27 48.3 1.50 0.045 1.01 2.22 41 45.1 329 31.1 1.35 0.07 0.97 1.87
Hozpitalization for heart failuree 94 8.6 5 8.9 0.87 0.8 0.35 2.15 87 8.2 12 13.2 1.41 0.3 0.77 2.59
Fatal or nonfatal myocardial infarctionf 194 17.8 13 23.3 1.34 0.3 0.76 2.36 186 17.6 21 23.1 1.24 0.4 0.79 1.95
Fatal or nonfatal ischemic strokeg 181 16.6 17 30.4 1.73 0.03 1.05 2.86 171 16.2 27 29.7 1.76 0.007 1.17 2.65
  1. a As some end points were composites, a participant who had events for more than one component of the composite (e.g., stroke and then acute myocardial infarction) would contribute only the first event that occurred to the composite end point but would contribute an event to the separate analyses of each component. Hence, summation of the number of events for separate components of a composite end point does not equate to the number of events for the composite end point. If there are fewer than five participants in a cell, then statistics are not reported to preserve participant’s privacy and potential unreliable statistical inferences
  2. b CVD incidence, a prespecified secondary end point, was a composite of fatal CHD (death from myocardial infarction, sudden cardiac death, or any other death in which the underlying cause was considered to be CHD), nonfatal myocardial infarction, fatal or nonfatal stroke (including haemorrhagic stroke), or hospitalization for heart failure. 50,887 person-years of observation (mean 4.43 ± 1.28SD years; median 4.51, IQR 3.48-5.53, range 0–7)
  3. c Fatal CVD was defined as any death from stroke (including haemorrhagic stroke) or CHD. 52,353 person-years of observation (mean 4.55 ± 1.21SD years, median 4.61, IQR 3.58-5.60, range 0–7). Fatal CVD assessed for competing events (cancer death, major haemorrhage death, other death)
  4. d Major adverse cardiovascular events, a non-prespecified end point, was a composite of fatal CHD (excluding death from heart failure), nonfatal myocardial infarction, or fatal or nonfatal ischemic stroke. 51,063 person-years of observation (mean 4.44 ± 1.26SD years, median 4.52, IQR 3.48-5.54, range 0–7)
  5. e 51,497 person-years of observation (mean 4.48 ± 1.24SD years, median 4.54, IQR 3.51-5.56, range 0–7)
  6. f 51,297 person-years of observation (mean 4.47 ± 1.25SD years, median 4.54, IQR 3.50-5.55, range 0–7)
  7. g Data for ischemic stroke included cases that were adjudicated as ischemic stroke, cases for which stroke type was uncertain after adjudication, and cases of ischemic stroke with haemorrhagic transformation. 51,349 person-years of observation (mean 4.47 ± 1.25SD years, median 4.54, IQR 3.50-5.55, range 0–7)
  8. h Adjusted based on a primary CVD risk assessment tool developed specifically from this cohort 28: age (years), gender (women, men), smoking (never, past, current), systolic blood pressure (mmhg), high-density lipoprotein (HDL-c; mmol/L), non-HDL (mmol/L), diabetes (yes, no), serum creatinine (mg/dL), and antihypertensive drug use (yes, no)
  9. i The social health composite categories were defined as positive (not isolated, supported, and not lonely), or poor (isolated, not supported and/or lonely)