J Am Heart Assoc
Loneliness tied to higher risk of degenerative valve disease
Clinical takeaway: Loneliness, not social isolation, was associated with higher risk of degenerative valvular heart disease and may represent a modifiable risk factor alongside lifestyle behaviors.
Heart valve disease is usually viewed as an age-related mechanical process, but emerging data suggest psychosocial factors may also contribute. This study examined whether loneliness and social isolation are associated with risk of degenerative valvular heart disease.
In a prospective cohort of 462,917 UK Biobank participants free of valvular disease at baseline, researchers followed outcomes for a median of 13.9 years. Loneliness and social isolation were assessed via questionnaire, with loneliness defined by subjective feelings of disconnection and inability to confide in others.
More than 11,000 participants developed degenerative valvular heart disease during follow-up. Compared with those reporting minimal loneliness, individuals with the highest loneliness scores had a 19% higher risk of overall valve disease, including a 21% higher risk of aortic stenosis and a 23% higher risk of mitral regurgitation. In contrast, social isolation, which was based on living situation and frequency of contact, was not associated with increased risk.
Loneliness was also associated with worse downstream outcomes, including higher rates of valve replacement, cardiovascular death, and major cardiovascular events among those who developed disease. Risk remained elevated regardless of genetic predisposition, although those with both high loneliness and high genetic risk had the greatest overall risk.
Lifestyle factors partially explained the relationship. Higher rates of smoking, obesity, physical inactivity, poor sleep, and alcohol use were more common in those reporting loneliness and mediated a portion of the increased risk, suggesting potential targets for intervention.
“Our results suggest that addressing loneliness could help delay disease progression, postpone surgical interventions such as valve replacement, and ultimately reduce the long-term clinical and economic burden of valvular heart disease,” said study co-author Cheng Wei, M.D., Ph.D. candidate in cardiovascular medicine at The Second Xiangya Hospital, Central South University in Changsha, Hunan, China.
Source: Cao C. J Am Heart Assoc. 2026 April 15. Social Disconnection, Genetic Risk, and the Incidence of Degenerative Valvular Heart Disease