title: Association between social isolation and left ventricular mass.
abstract: BACKGROUND
  Social isolation is associated with progression of cardiovascular disease, with the most socially isolated patients being at increased risk. Increased left ventricular mass is a predictor of cardiovascular morbidity and mortality. It is not yet clear whether social isolation is a determinant of increased left ventricular mass.
  
  
  METHODS
  We performed a cross-sectional study of Northern Manhattan Study participants who were free of clinical cardiovascular disease and had obtained transthoracic echocardiograms (n=2021) and a baseline questionnaire on social habits. Social isolation was defined as the lack of friendship networks (knowing fewer than 3 people well enough to visit within their homes). Echocardiographic left ventricular mass was indexed to height(2.7), analyzed as a continuous variable and compared between exposure groups.
  
  
  RESULTS
  The prevalence of social isolation was 13.5%. The average left ventricular mass was significantly higher (50.2 gm/m(2.7)) in those who were, as compared with those who were not (47.6 gm/m(2.7)), socially isolated (P<.05). Higher prevalence of social isolation was found among those less educated, uninsured, or unemployed. There were no significant race-ethnic differences in the prevalence of social isolation. In multivariate analysis, there was a trend toward an association between social isolation and increased left ventricular mass in the total cohort (P=.09). Among Hispanics, social isolation was significantly associated with greater left ventricular mass. Hispanics who were socially isolated averaged 3.9 gm/ht(2.7) higher left ventricular mass compared with those not socially isolated (P=.002). This relationship was not present among non-Hispanic blacks or whites.
  
  
  CONCLUSIONS
  In this urban tri-ethnic cohort, social isolation was prevalent and associated with indices of low socioeconomic status. Hispanics who were socially isolated had a greater risk for increased left ventricular mass.
authors.affiliation: Department of Medicine, Columbia University, New York, NY 10032, USA.
authors.forename: Carlos J
authors.initials: CJ
authors.lastname: Rodriguez
authors.forename: Mitchell S V
authors.initials: MS
authors.lastname: Elkind
authors.forename: Lynn
authors.initials: L
authors.lastname: Clemow
authors.forename: Zhezhen
authors.initials: Z
authors.lastname: Jin
authors.forename: Marco
authors.initials: M
authors.lastname: Di Tullio
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
authors.forename: Shunichi
authors.initials: S
authors.lastname: Homma
authors.forename: Bernadette
authors.initials: B
authors.lastname: Boden-Albala
mesh_terms: D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004452:Echocardiography; D004522:Educational Status; D005190:Family; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology*; D008297:Male; D017057:Medically Uninsured; D008875:Middle Aged; D015999:Multivariate Analysis; D009519:New York City / Q000453:epidemiology; D012044:Regression Analysis; D012107:Research Design; D012307:Risk Factors; D012923:Social Class; D012934:Social Isolation; D014478:Unemployment; D014505:Urban Population / Q000706:statistics & numerical data; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data