Unsocial Men: More Heart Disease Risk?

Avoiding Social Interaction Could Mean a Greater Risk of Death

Medically Reviewed by Louise Chang, MD on November 15, 2005

Nov. 14, 2005 (Dallas) - Men who avoid social interaction -- not bothering to say hello or even discuss the day's activities with friends or co-workers -- face an increased risk of death from heart disease.

"Social avoidance was associated with an increased risk of cardiovascular death independent of the men's baseline heart risk factors," Jarett Berry, MD, of Northwestern University, Chicago, told those attending the American Heart Association's Scientific Sessions.

When men who scored high on a social-avoidance scale were compared with men who clearly were more socially involved with co-workers and friends, the researchers found that men with social avoidance were 38% more likely to die from cardiovascular disease.

A 30-year study on 1,947 healthy men found that social avoidance was associated with age-adjusted increases in cardiovascular and heart disease deaths.

Rating Social Avoidance

All the participants had been measured on the Cook-Medley Hostility scale, which includes a subscale that identified the tendency for social avoidance.

"Social avoidance is the tendency to avoid social contact," said Berry. "There is a fear of social situations -- and shyness. In response, there is an exaggerated sympathetic nervous system response in the body."

What they found is men who had high levels of social avoidance were at increased risk of cardiovascular death, even when adjusted for other risk factors such as cholesterol levels, blood pressure, body mass index, alcohol consumption, and smoking.

Men who had high scores for social avoidance tended to avoid social contact, saying they weren't likely to speak to a friend they had not seen in a long time unless spoken to first. Nor were they likely to speak to anyone unless spoken to first; they didn't enter conversations or gossip and they stayed away from people for fear of saying something that they might regret.

The men in the study were 45 to 50 years of age and had an average of about 11 years of education. As a group they were overweight, had high total cholesterol levels, slightly elevated blood pressure, and smoked on average 10 cigarettes a day.

But when researchers adjusted for these heart disease risk factors, men with high social avoidance still had higher rates for death from heart disease.

Role of Depression

"Social avoidance is associated in increased risk of death from heart disease," said Berry. "One of the mechanisms in this may be depression and a lack of social support."

"Feelings of well-being, such as anxiety and depression, clearly can have an impact on cardiovascular disease, making it more severe or manifesting much earlier," said Robert Bonow, former president of the AHA and chief of cardiology at Northwestern Medical School in Chicago.

"People who are a little more confident, settled, and with a social structure withstand the disease better," said Bonow, who was not involved in the study.

"Clearly there are people at either end of the spectrum," he said.