Living Alone and Cardiovascular Risk in Outpatients at Risk of or With Atherothrombosis

BACKGROUND: Living alone, a proxy for social support, has been inconsistently linked with cardiovascular risk. METHODS: We investigated whether living alone was associated with increased mortality and cardiovascular risk in the global REduction of Atherothrombosis for Continued Health (REACH) Registry. Stable outpatients at risk of or with atherothrombosis were recruited from December 1, 2003, through December 31, 2004, and followed up to 4 years for cardiovascular events. Events were examined by living arrangement with risk adjustment for age, sex, clinical risk factors, therapy, preexisting vascular disease, and sociodemographic factors. Effect modification was tested by age, sex, employment, ethnicity, education, and geography. RESULTS: Among the 44 573 REACH participants, 8594 (19%) were living alone. Living alone was associated with higher 4-year mortality (14.1% vs 11.1%) and cardiovascular death (8.6% vs 6.8%; log-rank P 80 years: 24.6% vs 28.4%; adjusted HR, 0.92 95% CI, 0.79-1.06). A similar trend was observed for the risk of cardiovascular death. CONCLUSIONS: In an international outpatient population with atherothrombosis aged 45 years or older, living alone was associated with increased mortality among all but the most elderly patients, although this observation warrants confirmation.