Social networks are associated with lower mortality rates among women with suspected coronary disease: the National Heart, Lung, and Blood Institute-Sponsored Women's Ischemia Syndrome Evaluation study.
OBJECTIVE
To examine the association between social relationships measured by the Social Network Scale and coronary artery disease (CAD) risk and mortality among a sample of women with suspected CAD.


METHODS
Five hundred three women (mean age, 59 years) with suspected CAD warranting clinical investigation completed a diagnostic protocol including psychosocial testing, CAD risk factor assessment, and quantitative coronary angiography. Patients were subsequently followed for a mean of 2.3 years to track all-cause mortality.


RESULTS
Women reporting higher social network scores showed a consistent pattern of reduced coronary artery disease risk, including lower blood glucose levels (r = -0.11; p = .03), lower smoking rates (odds ratio [OR] = 0.81; 95% confidence interval [CI] = 0.71-0.93; p = .002), lower waist-hip ratios (r = -0.18; p < .01), and lower rates of hypertension (OR = 0.90; 95% CI = 0.81-0.99; p = .04) and diabetes (OR = 0.83; 95% CI = 0.73-0.94; p = .004). Based on quantitative angiogram findings, high social network scorers also had less severe CAD (mean angiogram stenosis value, 40.8 vs. 27.2 for low and high scoring social network groups, respectively; p < .001). Finally, mortality rates over follow-up showed a dose-response pattern in relation to quartile scorers on the Social Network Index, with low scorers showing more than twice the death rate of high scorers (relative risk = 2.4; p = .03).


CONCLUSIONS
Among a cohort of women with suspected CAD, smaller social circles were associated with increased CAD risk factors and mortality, an effect that appeared to be explained largely by income level. The findings extend previous studies of social network effects on health by highlighting risk among women with suspected CAD, and suggest mechanisms for further study.
Rutledge
Thomas
T
University of California, San Diego, San Diego, California, USA. Thomas.Rutledge@med.va.gov
Reis
Steven E
SE
Olson
Marian
M
Owens
Jane
J
Kelsey
Sheryl F
SF
Pepine
Carl J
CJ
Mankad
Sunil
S
Rogers
William J
WJ
Bairey Merz
C Noel
CN
Sopko
George
G
Cornell
Carol E
CE
Sharaf
Barry
B
Matthews
Karen A
KA
D001786:Blood Glucose / Q000032:analysis; D002423:Cause of Death; D015331:Cohort Studies; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000175:diagnosis; D007182:Income; D008137:Longitudinal Studies; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D012944:Social Support; D049629:Waist-Hip Ratio
D001786:Blood Glucose