OBJECTIVE: This study aimed to examine the prospective associations of loneliness and social isolation with the risk of Cardiovascular-Kidney-Metabolic Syndrome Stages 0-3 progression to cardiovascular disease (CVD) and to compare the relative importance of loneliness and social isolation with traditional risk factors. In addition, the interactions of loneliness or isolation with the degree of risk factor control in relation to CVD risk were evaluated. METHOD: This national prospective cohort study included 3,500 participants from the China Health and Retirement Longitudinal Study. Loneliness and social isolation were self-reported. The degree of risk factor control was defined as the number of glycated hemoglobin (HbA1c), blood pressure, low-density lipoprotein cholesterol, smoking, and kidney condition controlled within the target range. Cox proportional hazards models and interaction analyses were used to estimate risk for CVD. RESULTS: ] = 58.58 8.72 years), 1,615 (45.1%) were men. Over a median follow-up of 7.1 years, 714 participants developed CVD. Loneliness, but not social isolation, was independently associated with increased CVD risk (adjusted hazard ratio = 1.25, 95% confidence interval 1.02, 1.52. Loneliness ranked fourth among predictors, following low-density lipoprotein cholesterol, systolic blood pressure, and body mass index. Joint analysis showed that individuals who were lonely and had a low risk factor control had the highest CVD risk (hazard ratio = 1.91, 95% confidence interval 1.43, 2.54, with significant additive and multiplicative interactions. CONCLUSIONS: Loneliness, but not social isolation, is associated with a higher risk of cardiovascular-kidney-metabolic syndrome progression to CVD and shows an interaction with the degree of risk factor control. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Liu et al. (Mon,) studied this question.