The support of family, friends and others may be key in how well a person recovers after a heart attack, according to a new report.

In a review of five studies, researchers in Canada found that heart attack sufferers who had few people to turn to, or who felt they lacked the support they needed, were more likely than other patients to die over the next several years.

Men and women who felt the least supported were two to three times more likely to die after a heart attack. This relationship held regardless of clinical factors such as overall heart function, high blood pressure and age, according to findings published in the Archives of Internal Medicine.

Some research has suggested that in the year after a heart attack, a lack of social support is as important a risk factor for premature death as High cholesterol, smoking and high blood pressure.

The reasons are not fully clear, but it’s thought that poor support can negatively affect the body, mind and behavior. Physical effects may include changes in the immune response, hormonal and nervous systems, and the blood circulation, the study authors note.

While a person’s need for emotional support may not be remedied as easily as High cholesterol, doctors can begin to do more to address the problem, according to co-author Dr. Heather M. Arthur.

“We could start by being much more systematic about assessing for issues related to social support,” she told Reuters Health.

Some “simple questions” added to routine evaluations could help spot patients who need to be referred for help, said Arthur, who is with McMaster University in Hamilton, Ontario.

In their report, she and colleague Dr. Farouk Mookadam point to some studies that have suggested ways to give patients the support they need. In one study that Arthur led, a support group for women with heart disease appeared to aid recovery after hospital discharge. Women in that group said they often bottled up their emotions around family and friends, but felt their support-group peers were better able to understand them.

Another possibility, Arthur and Mookadam suggest, could be to make heart attack rehabilitation into a more social activity - creating, for instance, a “buddy system” that partners a patient with little social support with another who has a strong network of family and friends.

However, the researchers say, little is known about the best way to aid patients lacking support, and much more study is needed.

SOURCE: Archives of Internal Medicine, July 26, 2004.