Association Between Social Isolation and Risk of Hypertension Among the Middle-aged and Older: A Propensity Score–matched Cohort Study

Authors

Yiting Kang, School of Health Science, Mae Fah Luang University, Thailand.Follow
Minchao Liu, School of Clinic Medicine, Chengdu University of Traditional Chinese Medicine, ChinaFollow

Abstract

Background: Social isolation has emerged as a growing public health concern and may be an underrecognized risk factor for hypertension. However, evidence on its longitudinal association with hypertension remains limited and inconsistent.

Methods: The data of the national cohort study were collected from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020. A total of 3280 participants aged 45 years and older without hypertension at baseline were included. Propensity score matching (PSM) was applied to balance covariates between socially isolated and non-isolated groups. Cox proportional hazards models were used to estimate the association between social isolation and incident hypertension.

Results: 14.57% of middle-aged and older adults in this study were classified as socially isolated. After matching, a total of 470 socially isolated individuals were successfully matched to 470 non-isolated counterparts. The Kaplan–Meier cumulative incidence curves demonstrated a consistently significant association between social isolation and the incidence of hypertension, both before and after PSM (p = 0.0093; p =0.0215). Subgroup analyses showed the association remained robust among individuals among the middle-aged, men, individuals with lower education levels, smokers, those without major chronic conditions, and those with medical insurance. No significant interactions were found across subgroups.

Conclusion: This association persisted after PSM and adjustment for some key confounders, highlighting the role of social factors in shaping hypertension risk and warranting further investigation.

Keywords: Social isolation, Hypertension, Propensity score matching, the Middle-aged and older

Recommended Citation

Kang Y, Liu M. Association Between Social Isolation and Risk of Hypertension Among the Middle-aged and Older: A Propensity Score–matched Cohort Study. J Health Res. 2025; 39(6):-. DOI: https://doi.org/10.56808/2586-940X.1174

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