Loneliness Identified as Potential Risk Factor for Degenerative Heart Valve Disease

Adults who reported feeling lonely had a higher risk of developing degenerative heart valve disease, even after accounting for traditional heart disease risk factors and genetics, according to new research published in the Journal of the American Heart Association. The study, which analyzed data from approximately 463,000 adults in the UK Biobank, found that loneliness, but not social isolation, was significantly associated with an increased risk of valve disease over a median follow-up period of nearly 14 years. This suggests loneliness may be an independent and potentially modifiable risk factor that could help reduce the incidence of degenerative valvular heart disease.

Valvular heart disease occurs when one of the heart's four valves stops functioning properly. According to the American Heart Association's 2026 Heart Disease and Stroke Statistics Report, valvular heart disease accounted for more than 440,000 deaths in the U.S. between 1999 and 2020. Degenerative valvular heart disease, where heart valves gradually become stiff or leaky over time, is becoming more common as populations age. Study author Zhaowei Zhu, M.D., Ph.D., noted that identifying loneliness as a new risk factor is an important step in potentially preventing valve disease, which can lead to heart failure, reduced quality of life, and the need for valve replacement surgery.

During the study period, more than 11,000 new cases of degenerative valvular heart disease were diagnosed. Among those, more than 4,200 cases were aortic valve stenosis, and nearly 4,700 were mitral valve regurgitation. Compared with people who reported minimal loneliness, those with the highest level of loneliness had a 19% higher risk of developing degenerative valvular heart disease overall, a 21% higher risk of aortic valve stenosis, and a 23% higher risk of mitral valve regurgitation. The analysis revealed that about 28% of participants reported higher levels of loneliness. Unhealthy lifestyle behaviors, such as obesity, smoking, excess alcohol consumption, suboptimal sleep duration, or irregular physical activity, partially explained the relationship between loneliness and valvular heart disease.

Researchers emphasized that loneliness appeared to increase the risk regardless of a person's genetic background. However, people who had both high genetic risk for heart valve disease and high loneliness scores had the highest risk of valvular heart disease diagnosis. In contrast, social isolation, defined by objective measures like living alone or having little social contact, was not significantly associated with increased risk for any valvular heart disease conditions. This distinction is crucial, as loneliness pertains to the subjective feeling of being alone or lacking meaningful connections, regardless of one's social circumstances.

Crystal Wiley Cene, M.D., M.P.H., FAHA, an American Heart Association volunteer expert who was not involved in the study, explained that loneliness is a stressor for the body that can damage health. She noted that loneliness is about the quality of relationships, not quantity, and represents a mismatch between the connections a person desires and what they have. The aging process can cause degeneration of heart valves, and the risk of social isolation and loneliness also increases with age, making the association between loneliness and heart valve disease plausible. Both study co-author Cheng Wei, M.D., and Cene encourage people to discuss feelings of loneliness with healthcare professionals and for professionals to encourage patients to engage in meaningful social connections.

Study limitations include its observational nature, meaning it cannot prove that loneliness directly caused valvular heart disease, only that an association exists. Another limitation is that loneliness was measured using self-reported questionnaires at a single point in time, which does not capture changes over time. Additionally, most participants were white adults, which may limit how broadly the results apply to people in other racial or ethnic groups. Future studies are needed to confirm these findings in more diverse populations, understand the biological mechanisms linking loneliness and valve degeneration, and test whether interventions that reduce loneliness can lower the risk of valvular heart disease.