PT - JOURNAL ARTICLE AU - Janine Gronewold AU - Rene Kropp AU - Nils Lehmann AU - Börge Schmidt AU - Simone Weyers AU - Johanne Siegrist AU - Nico Dragano AU - Karl-Heinz Jöckel AU - Raimund Erbel AU - Dirk M Hermann ED - , TI - Association of social relationships with incident cardiovascular events and all-cause mortality AID - 10.1136/heartjnl-2019-316250 DP - 2020 Sep 01 TA - Heart PG - 1317--1323 VI - 106 IP - 17 4099 - http://heart.bmj.com/content/106/17/1317.short 4100 - http://heart.bmj.com/content/106/17/1317.full SO - Heart2020 Sep 01; 106 AB - Objective To examine how different aspects of social relationships are associated with incident cardiovascular events and all-cause mortality.Methods In 4139 participants from the population-based Heinz Nixdorf Recall study without previous cardiovascular disease (mean (SD) age 59.1 (7.7) years, 46.7% men), the association of self-reported instrumental, emotional and financial support and social integration at baseline with incident fatal and non-fatal cardiovascular events and all-cause mortality during 13.4-year follow-up was assessed in five different multivariable Cox proportional hazards regression models: minimally adjusted model (adjusting for age, sex, social integration or social support, respectively); biological model (minimally adjusted+systolic blood pressure, low-density and high-density lipoprotein cholesterol, glycated haemoglobin, body mass index, antihypertensive medication, lipid-lowering medication and antidiabetic medication); health behaviour model (minimally adjusted+alcohol consumption, smoking and physical activity); socioeconomic model (minimally adjusted+income, education and employment); and depression model (minimally adjusted+depression, antidepressants and anxiolytics).Results 339 cardiovascular events and 530 deaths occurred during follow-up. Lack of financial support was associated with an increased cardiovascular event risk (minimally adjusted HR=1.30(95% CI 1.01 to 1.67)). Lack of social integration (social isolation) was associated with increased mortality (minimally adjusted HR=1.47 (95% CI 1.09 to 1.97)). Effect estimates did not decrease to a relevant extent in any regression model.Conclusions Perceiving a lack of financial support is associated with a higher cardiovascular event incidence, and being socially isolated is associated with increased all-cause mortality. Future studies should investigate how persons with deficient social relationships could benefit from targeted interventions.