Associations between hypertension care cascade, cognitive function, and cardiovascular disease in middle-aged and older adults: the exacerbated role of social isolation

Background: The role of social isolation in the connections between the hypertension care cascade, cognitive function, and cardiovascular disease (CVD) remains unclear. This study aims to investigate the relationships between the hypertension care cascade, cognitive performance, and CVD among middle-aged and older adults with varying levels of social isolation. Methods: Eight thousand two hundred eighty-seven participants aged 45 years and older from the China Health and Retirement Longitudinal Study were included in the analysis. Participants were categorized based on their social isolation status, either as socially isolated or not. Both multivariable linear regression and logistic regression models were employed. All analyses were weighted to account for the multistage, probability-proportional-to-size sampling design of the study. Hypertension was defined according to European, Chinese, and American guidelines. Results: for interaction < 0.05). Conclusions: Individuals experiencing social isolation exhibited poor performance in the hypertension care cascade. Furthermore, social isolation significantly exacerbated the negative effects of poor hypertension care cascade on cognitive function and CVD. Our study emphasizes that addressing social isolation could be a significant factor for improving the hypertension care cascade and health outcomes among middle-aged and older adults in China.