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Association between Social Isolation and Left Ventricular Mass - 19/08/11

Doi : 10.1016/j.amjmed.2010.09.011 
Carlos J. Rodriguez, MD, MPH a, b, , Mitchell S.V. Elkind, MD, MS b, c, Lynn Clemow, PhD a, Zhezhen Jin, PhD d, Marco Di Tullio, MD a, Ralph L. Sacco, MD, MS e, Shunichi Homma, MD a, Bernadette Boden-Albala, DrPH c, f
a Department of Medicine, Columbia University, New York, NY 
b Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY 
c Department of Neurology, Columbia University, New York, NY 
d Department of Biostatistics, Columbia University, Mailman School of Public Health, New York, NY 
f Department of Sociomedical Science, Columbia University, Mailman School of Public Health, New York, NY 
e Department of Neurology, University of Miami, Fla 

Requests for reprints should be addressed to Carlos J. Rodriguez, MD, MPH, Division of Cardiology, Columbia University, College of Physicians & Surgeons, 630 West 168th Street, New York, NY 10032

Abstract

Background

Social isolation is associated with progression of cardiovascular disease, with the most socially isolated patients being at increased risk. Increased left ventricular mass is a predictor of cardiovascular morbidity and mortality. It is not yet clear whether social isolation is a determinant of increased left ventricular mass.

Methods

We performed a cross-sectional study of Northern Manhattan Study participants who were free of clinical cardiovascular disease and had obtained transthoracic echocardiograms (n=2021) and a baseline questionnaire on social habits. Social isolation was defined as the lack of friendship networks (knowing fewer than 3 people well enough to visit within their homes). Echocardiographic left ventricular mass was indexed to height2.7, analyzed as a continuous variable and compared between exposure groups.

Results

The prevalence of social isolation was 13.5%. The average left ventricular mass was significantly higher (50.2 gm/m2.7) in those who were, as compared with those who were not (47.6 gm/m2.7), socially isolated (P<.05). Higher prevalence of social isolation was found among those less educated, uninsured, or unemployed. There were no significant race-ethnic differences in the prevalence of social isolation. In multivariate analysis, there was a trend toward an association between social isolation and increased left ventricular mass in the total cohort (P=.09). Among Hispanics, social isolation was significantly associated with greater left ventricular mass. Hispanics who were socially isolated averaged 3.9 gm/ht2.7 higher left ventricular mass compared with those not socially isolated (P=.002). This relationship was not present among non-Hispanic blacks or whites.

Conclusion

In this urban tri-ethnic cohort, social isolation was prevalent and associated with indices of low socioeconomic status. Hispanics who were socially isolated had a greater risk for increased left ventricular mass.

El texto completo de este artículo está disponible en PDF.

Keywords : Hispanics, Left ventricular mass, Psychosocial factors, Social isolation


Esquema


 Funding: RLS, MSV (R01 NS29993), and MDT (K24 NS02241) are supported by the National Institute of Neurological Disorders and Stroke. CJR is supported by the Robert Wood Johnson Foundation Harold Amos Medical Faculty Development Award, and a National Heart, Lung, and Blood Institute Mentored Research Career Development Award (K23 HL079343-01A2).
 Conflict of Interest: The authors report no conflicts of interest.
 Authorship: The authors had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. All of the authors meet criteria for authorship, including acceptance of responsibility for the scientific content of the manuscript.


© 2011  Elsevier Inc. Reservados todos los derechos.
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P. 164-170 - février 2011 Regresar al número
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