Isolation Increases Risk of High Blood Pressure, Especially For Women

Staying at home and avoiding close contact with others are critical ways to curb the spread of COVID-19. But while following guidelines is an important part of protecting public health at large, social isolation can have a negative impact on the health of individuals—especially women.

A recent study from Canada has found that women who are single and socially isolated face a higher likelihood of having high blood pressure. Interestingly, marital status and social participation didn't have much effect on hypertension rates in men. The most important important variable for men was living situation: Men who lived with other people were much more likely to have high blood pressure than men who lived alone.

The findings could provide insight into how people of different genders may fare over the long term as we head into a winter of lockdowns. 

Social Isolation and Heart Health

In the Canadian study, published in the Journal of Hypertension, researchers from British Columbia looked at data from the Canadian Longitudinal Study on Aging on 28,238 adults between 45 and 85 years old.

The study asked participants about their marital status, living arrangements, social network size, and participation in social activities. It also collected information on which participants had hypertension, which was defined as 140/90 mmHg, or more than 130/80 mmHg in participants who had diabetes.

The data showed that single women tended to have a higher risk of hypertension than married women. More specifically, the risk was 28% higher for single women, 21% higher for divorced women, and 33% higher for widowed women compared with their married counterparts.

Researchers also found a strong association in rates of high blood pressure in women based on their social networks, which included work colleagues, close friends, relatives, children, siblings, and neighbors. Women with the smallest social networks (85 people or less) were 15% more likely to have hypertension compared with participants who had the largest social groups (220 people or more).

Women who participated in few or no social activities, like family gatherings, clubs, or sports, within the last year were up to 30% more likely to have hypertension.

“We know that when we’re together with other people, we’re happier, we’re healthier, and now we have hard evidence that our heart is working better,” says Petros Levounis, MD, professor and chair of the psychiatry department at the Rutgers New Jersey Medical School and chief of service at University Hospital. (Levounis was not involved in the Canadian research.)

Things were a little different among men. Men who lived with other people were 15% more likely to have hypertension than those who lived alone (co-living had no significant effect on women). Like women, men who were single, divorced, or widowed also had increased risk of high blood pressure, but the association was much weaker.

The impact of social participation was also much smaller for men. Finally, the size of a man’s social network didn’t have a significant effect on his risk of hypertension. 

Understanding Gender Differences

The overall findings of this study echo earlier research, which has found that older adults who have partners and are more socially active tend of have lower rates of hypertension. According to the Centers for Disease Control and Prevention (CDC), social isolation also comes with higher risk of early death that rivals the mortality risk of smoking, obesity, and lack of exercise.

However, the gender-based differences in this research (particularly in regard to lower rates of hypertension among men who live alone) have not been seen in two other studies on the subject.

The authors think that the effect may be the result of many lone-living older men residing in senior housing communities that offer opportunities to interact with others and access information on health. They also suspect that the lower rates of hypertension seen in married people may be the result of “different social and economic expectations” that come with being in a partnership in Canada.

More research is needed to determine exactly why the effects of social isolation and hypertension differed between men and women, says Leonard Pianko, MD, cardiologist at Aventura Cardiovascular Center in Florida.

“My hypothesis is that women have a different response to loneliness than men because they produce more epinephrine from the adrenal gland, and that produces hormones and neurotransmitters that elevate blood pressure,” he explains.

Isolation and Mental Health

Social isolation not only makes an impact on cardiovascular health. It has ripple effects on our psychological and emotional well-being too.

In a 2017 review of 40 other studies on the public health consequences of social isolation, researchers found that loneliness was associated with poor mental health outcomes. Loneliness has also been found to increase a person’s risk for suicide, depression, and anxiety.

Given the negative health effects of isolation, Dr. Pianko hopes that questions about a patient’s social life will become a routine part of health screenings. “Doctors should be asking, ‘Who’s at home with you? What social contacts are you having?’ This is a real thing and it’s often overlooked,” he says.

The rising rates of COVID-19 infections mean that we may be in for at least a few more months of staying home and limiting our contact with others. That’s why it’s more important than ever to get creative and find other ways to connect with friends, family, and colleagues to maintain your health and fend off feelings of loneliness.

“Don’t write off the virtual gatherings,” says Dr. Levounis. “Virtual parties and dating and connections of all sorts may not be on par with the real thing, but something is better than nothing.”

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