Heartbeat: is cardiovascular health affected by marital status, living alone or loneliness?

Many studies suggest there is a higher risk of cardiovascular disease (CVD) in individuals who are lonely, not married or living alone.1–4 But which is it: a feeling of loneliness, living by yourself or being married that counts? And is this association mediated by psychological factors; lifestyle behaviours such as diet, exercise and not smoking; or variation in healthcare use including CVD risk reduction treatments? Additionally, are biological factors important? For example, it has been hypothesised that telomere length, which is a marker of biological ageing and psychological distress, might explain the association between living alone and CVD risk.

In this issue of Heart, Chen and colleagues5 examined the relationship between marital status, leucocyte telomere length (LTL) and incidence CVD using data from over 10 000 participants in the Swedish Twin Registry. Compared with people who were married or cohabiting,…

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