Social networks and incident stroke among women with suspected myocardial ischemia.
OBJECTIVE
To describe the prospective relationship between social networks and nonfatal stroke events in a sample of women with suspected myocardial ischemia. Social networks are an independent predictor of all-cause and cardiovascular mortality, but their relationship with stroke events in at-risk populations is largely unknown.


METHODS
A total of 629 women (mean age = 59.6 +/- 11.6 years) were evaluated at baseline for cardiovascular disease risk factors as part of a protocol including coronary angiography; the subjects were followed over a median 5.9 years to track the incidence of cardiovascular events including stroke. Participants also completed the Social Network Index (SNI), measuring the presence/absence of 12 types of common social relationships.


RESULTS
Stroke events occurred among 5.1% of the sample over follow-up. More isolated women were older and less educated, with higher rates of smoking and hypertension, and increased use of cardiovascular medications. Women with smaller social networks were also more likely to show elevations (scores of > or =10) on the Beck Depression Inventory (54% versus 41%, respectively; p = .003). Relative to women with higher SNI scores, Cox regression results indicated that more isolated women experienced strokes at greater than twice the rate of those with more social relationships after adjusting for covariates (hazard ratio = 2.7; 95% Confidence Interval = 1.1-6.7).


CONCLUSIONS
Smaller social networks are a robust predictor of stroke in at-risk women, and the magnitude of the association rivals that of conventional risk factors.
Rutledge
Thomas
T
Department of Psychiatry, VA San Diego Healthcare System, University of California, San Diego, CA 92161, USA. Thomas.Rutledge@va.gov
Linke
Sarah E
SE
Olson
Marian B
MB
Francis
Jennifer
J
Johnson
B Delia
BD
Bittner
Vera
V
York
Kaki
K
McClure
Candace
C
Kelsey
Sheryl F
SF
Reis
Steven E
SE
Cornell
Carol E
CE
Vaccarino
Viola
V
Sheps
David S
DS
Shaw
Leslee J
LJ
Krantz
David S
DS
Parashar
Susmita
S
Merz
C Noel Bairey
CN
D000328:Adult; D000368:Aged; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007398:Interpersonal Relations; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000523:psychology*; D010555:Personality Inventory; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D012944:Social Support; D013223:Statistics as Topic; D020521:Stroke / Q000453:epidemiology / Q000523:psychology*; D014481:United States