Having good friends can save your life, as a study based on data from the Women's Health Initiative (WHI) demonstrates how strong social support may reduce the risk of death from cardiovascular disease (CVD) in postmenopausal women. Study results are published online today in Menopause, the journal of The North American Menopause Society (NAMS).
Although rates of CVD morbidity and mortality have declined in recent decades, CVD remains a primary cause of death in Americans. Traditionally thought of as primarily a man's disease, women's rates of CVD have nearly caught up to men's rates (35.9% of American women have CVD vs 37.4% of men).
With so many people affected by CVD, there has been tremendous research on its various risk factors (although much of the focus to date has been on traditional risk factors such as smoking and hypertension). A few studies have focused on the effect of social support, but this recent study is the largest to date to evaluate the effect of social support on CVD and all-cause mortality in women.
After nearly 11 years of follow-up with participants in the WHI, researchers concluded that in women free of CVD at baseline, perceived social support is associated with a slightly lower risk of all-cause mortality. Although the association is described as modest, it remains significant. No major association was observed in women with a history of CVD. The researchers hypothesized that these results demonstrate the benefits of social support in either promoting stress relief or helping to buffer stressful life events. However, they have indicated that further clarification and investigation are necessary.
Previous studies have shown social support to be inversely associated with cardiovascular disease (CVD) in men, whereas fewer studies have assessed the relationship in women. The purpose of this study was to evaluate the relationship between perceived social support and cardiovascular outcomes among postmenopausal women enrolled in the Women's Health Initiative Observational Study.
We examined the relationships between perceived social support and (1) incident coronary heart disease (CHD), (2) total CVD, and (3) all-cause mortality. Participants were Women's Health Initiative Observational Study women, ages 50 to 79 years, enrolled between 1993 and 1998 and followed for up to 10.8 years. Social support was ascertained at baseline via nine questions measuring the following functional support components: emotional/informational, tangible, positive social interaction, and affectionate support.
Among women with prior CVD (n = 17,351) and no prior CVD (n = 73,421), unadjusted hazard ratios ranged from 0.83 to 0.93 per standard deviation increment of social support. Adjustment for potential confounders, such as smoking and physical activity levels, eliminated the statistical significance of the associations with CHD and CVD. However, for all-cause mortality and among women free of baseline CVD, the association was modest but remained statistically significant after this adjustment (hazard ratio = 0.95 [95% confidence interval, 0.91-0.98]). No statistically significant association was observed among women with a history of CVD.
After controlling for potential confounding variables, higher perceived social support is not associated with incident CHD or CVD. However, among women free of CVD at baseline, perceived social support is associated with a slightly lower risk of all-cause mortality.