Friends fortify women's hearts

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The size and strength of a woman's social circle may well be a factor in the health of her heart, a new study says.

The study, funded by the National Heart, Lung and Blood Institute and published in the journal Psychosomatic Medicine, is among the first to link social isolation to increased risk of death in women suspected of having heart disease.

"In my view, the number one take-home message is that if you're a woman with chest discomfort, have a lot of friends," said Dr. Carl J. Pepine, chief of cardiovascular medicine at the University of Florida's College of Medicine and an author of the multicenter study.

Dr. Pepine and a team of researchers from seven other medical institutions nationwide examined 503 women with chest discomfort, a frequent sign of coronary-artery disease. The women, whose average age was 59, underwent a battery of tests -- including coronary angiography -- to determine whether they had blocked arteries.

Most did not have severe heart disease, but many suffered from depression or other forms of psychological distress. The women completed questionnaires designed to indicate how many friends they had and to evaluate, over two weeks, how much contact they had with family and friends and how frequently they participated in social and recreational activities.

About half the women studied reported having smaller social networks -- meaning fewer than six relationships with family members or friends. Researchers then tracked the women's health for two to four years.

"Women reporting higher social-network scores showed a consistent pattern of reduced coronary-artery disease risk, including lower blood-glucose levels ... lower smoking rates ... lower waist-hip ratios, and lower rates of hypertension [high blood pressure], diabetes" and depression, the authors write.

They further note that "based on quantitative angiogram findings, high social scorers also had less severe [coronary-artery disease]," than low social scorers. Specifically, 67 percent of the low social-network group were found to have underlying CAD on an angiogram, compared with 54 percent in the high social-network contingent.

Of the women studied, 30 died during the follow-up period. The researchers say those with smaller social networks were 2.4 times more likely to die early. Low income and heart-disease risk levels also were associated with the women's deaths, particularly those women who earned less than $20,000 annually.

Dr. Pepine said women at that wage level are "in the lowest part of the distribution of the social network and, therefore, in the highest-risk categories for mortality."

He added: "These findings would suggest that strong social support networks are very important in modifying the risk from coronary heart disease."

Dr. Thomas Rutledge, assistant professor of psychiatry at the University of California, San Diego, and the study's lead author, said it is not yet fully understood how a social relationship benefits health.

One possibility, he said, is that people who are worse off physically and financially tend to be more socially isolated because they have to stay closer to home and cannot afford to meet friends for lunch or engage in other social activities.

"And having people around if you are sick makes a big difference," Dr. Rutledge said. "If you're at home and you're alone, and you don't have a husband, and you don't have friends nearby, and you have a heart attack or a stroke, isn't your risk of dying much greater than if someone's in the house or close by to help you get to the hospital? Probably so."

Charlotte Hayes, senior editor at the Independent Women's Forum, said, "It absolutely stands to reason" that strong social and family relationships are good for the heart and one's health in general.

"Friendship is just about the most important thing there is in the world. Of course, it keeps you alive, because it gives you something to live for," Miss Hayes said.

Janice Crouse, a senior fellow at the Beverly LaHaye Institute, said the study's findings support her organization's research that strong social networks are good for health.

"These results reinforce what research has shown about men for years: that men with strong family relationships and friendships have fewer heart attacks. It stands to reason the same would be true for women," she said.

Eileen Resnick, science program manager for the Society of Women's Health Research, said of the findings: "It's hard to draw a conclusion, but it is possible that social networks and emotions play a part in health in general. But I would have preferred that the report included men as well as women."