It is well-known that our hearts often respond to our emotional state. For example, broken heart syndrome, also known as stress-induced cardiomyopathy or takotsubo cardiomyopathy, is a recently recognized heart problem.

Broken heart syndrome was originally reported in the Asian population in 1990 and named takotsubo cardiomyopathy, a condition in which the heart is so weak that it assumes a bulging shape.

Symptoms of broken heart syndrome can look like those of a heart attack. Although most heart attacks are caused by blockages and blood clots forming in the coronary arteries, broken heart syndrome is quite different.

Most people who experience a broken heart have normal coronary arteries, without severe blockages or clots. The heart cells are stunned by stress hormones but not killed, and the effects often reverse within just a few days or weeks, usually with no lasting heart damage.

But a broken heart may not be the only emotional stressor that affects our hearts. Loneliness may also be bad for the heart and could even lead to premature death.

In a national survey of adults age 45 years and older, over one-third (35 percent) of the survey respondents were categorized as lonely. Older adults reported lower rates of loneliness than those who were younger (43 percent of those age 45-49 were lonely compared to 25 percent of those over age 70). Married respondents were less likely to be lonely (29 percent) compared to never-married respondents (51 percent).

A 2012 study reported that patients who have had a spouse die suddenly are 20 times more likely to die from a cardiovascular event such as a heart attack in the first six weeks surrounding the loss.

In another study of 479,054 individuals from the UK Biobank, isolated and lonely persons demonstrated an increased risk of acute myocardial infarction and stroke, and, among those with a history of acute myocardial infarction or stroke, increased risk of death. Most of this risk was explained by conventional risk factor.

In a new study, recently presented at EuroHeartCare 2018, the European Society of Cardiology’s annual nursing congress, researchers further confirmed that loneliness is bad for the heart for both men and women living alone.

This study investigated whether poor social networking was associated with worse outcomes in 13,463 patients with ischemic heart disease, arrhythmias, heart failure or heart valve disease. Data from national registers was linked with the DenHeart survey, which asked all patients discharged from April 2013 to April 2014 from five heart centers in Denmark to answer a questionnaire about their physical and mental health, lifestyle factors and social support.

Social support was measured using registry data on living alone and survey questions about feeling lonely. Questions were developed to collect information on both those who live alone but do not feel lonely and those who cohabit but do feel lonely.

The researchers found that feeling lonely was associated with poor outcomes in all patients regardless of their type of heart disease, even after adjusting for age, level of education, other diseases, body mass index, smoking and alcohol intake. In fact, loneliness was associated with a doubled mortality risk in women and nearly doubled risk in men.

Both men and women who felt lonely were three times more likely to report symptoms of anxiety and depression and had a significantly lower quality of life than those who did not feel lonely.

According to Anne Vinggaard Christensen, study author and Ph.D. student at The Heart Centre in Copenhagen University Hospital, we all live in a time when loneliness is more present, and health providers should take this into account when assessing risk, particularly asking patients questions about social support.