Association of social isolation and loneliness with the risk of hypertension in middle aged and older adults: Findings from a national representative longitudinal survey

Background: Social isolation and loneliness have been proved to be associated with many adverse health outcomes, but their influence on hypertension remains unclear. This study aimed to assess the relationship of social isolation and loneliness with hypertension risk among middle-aged and older adults in China. Methods: We used data from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study. Participants were assessed for social isolation and loneliness at baseline, and hypertension was identified by selfreport and blood pressure measurement at follow-up in 2015. Binary logistic regression analyses were conducted to assess the association of social isolation and loneliness with the risk of hypertension. Results: A total of 3711 residents were included. 13.7 % of the participants had high level of social isolation and 18.1 % felt lonely. During the four-year follow up period, 651 participants developed hypertension. People with high level of social isolation had an increased risk of hypertension (odds ratio [OR]: 1.40, 95 % confidence interval [CI]: 1.09-1.79). Similar results were found between social isolation score and hypertension risk (OR: 1.14, 95 % CI: 1.04-1.26). No significant association between loneliness and hypertension or any interaction effect of social isolation and loneliness on hypertension were observed. Limitations: Limited by the structure of questionnaire, some of the information was derived by self -report, which may lead to recalling bias. Conclusion: Social isolation, rather than loneliness was associated with hypertension for middle aged and older adults. Social support needs to be strengthened for hypertension prevention in community.