Living alone was associated with an increased risk of death and cardiovascular（心血管的） death in an international study of stable outpatients at risk of or with arterial vascular disease (such as coronary disease or peripheral周围的 vascular disease), according to a report published Online First by Archives of Internal Medicine, a JAMA Network publication. Social isolation may be associated with poor health consequences, and the risk associated with living alone is relevant because about 1 in 7 American adults lives alone. Epidemiological evidence suggests that social isolation may alter neurohormonal-mediated emotional stress, influence health behavior and effect access to health care, which may result in association with or acquisition of, cardiovascular risk, according to the study background.

Jacob A. Udell, M.D., M.P.H., of Brigham and Women's Hospital, Harvard Medical School, Boston, and colleagues examined whether living alone was associated with increased mortality and cardiovascular (CV) risk in the global REduction of Atherothrombosis for Continued Health (REACH) Registry. Among 44,573 REACH participants, 8,594 (19 percent) lived alone.

Living alone was associated with higher four-year mortality (14.1 percent vs. 11.1 percent) and cardiovascular death (8.6 percent vs. 6.8 percent), according to the study results.

Based on age, living alone was associated with an increased risk of death among those patients 45 to 65 years old compared with those living with others (7.7 percent vs. 5.7 percent) , and among those participants 66 to 80 years old (13.2 percent vs. 12.3 percent). However, among patients older than 80 years, living alone was not associated with an increased risk of mortality compared with those living with others (24.6 percent vs. 28.4 percent), the results indicate.

"In conclusion, living alone was independently associated with an increased risk of mortality and CV death in an international cohort of stable middle-aged outpatients（门诊病人） with or at risk of atherothrombosis," the authors conclude. "Younger individuals who live alone may have a less favorable course than all but the most elderly individuals following development of CV disease, and this observation warrants confirmation in further studies."