Last year, at her annual physical, one of my patients told me that February was the hardest time of the year for her. Her husband died three years earlier in February. Her daughter lives out of state and doesn’t visit often. She has a neurologic condition which makes it difficult for her to get around. Her days are marked by TV dinners eaten alone, a phone that rarely rings, and a television that fills the quiet background noise with images of roses, candies, crowded restaurants, and people blissfully in love. Constant reminders that she is not only alone, but lonely.

Reviewing her medical record, I noticed an interesting pattern. During February, her blood pressure climbs, her diabetes is harder to control, and her prior hospitalizations for heart failure were in February.

As a primary care doctor, health system executive, and researcher who studies how social connections affect your heart health, I have seen this pattern often. Loneliness doesn’t just hurt emotionally. It quietly harms the heart. Yet, we rarely talk about it or recommend strategies to combat its negative effects on health and well-being.

The physical toll of loneliness

February, American Heart Month, is a time when we focus on heart health and celebrate Valentine’s Day. During this month of love, we should remember that many people are alone and lonely. Social isolation and loneliness don’t just make people feel bad, they are bad for your health.

Over four decades of scientific research has shown that social isolation, not having enough meaningful connection with others, increases the risk of early death to a degree similar to obesity, smoking, and physical inactivity.

People who lack social connection have about a 30 percent higher risk of developing heart disease and a 20 percent risk of being hospitalized or dying from heart failure. After a heart attack, socially isolated individuals face two to three times higher risk of dying.

Nearly one in four Americans aged 65 years and older are socially isolated and almost half of Americans report feeling lonely. Young adults, women, low-income communities, immigrants, people with disabilities and multiple chronic conditions, and people living in rural areas are especially high risk, a problem made worse by the COVID-19 pandemic.

Wired for connection

Humans are wired for connection. When connection is lacking, the body interprets that absence as a threat. Stress hormones rise. Inflammation increases. Blood vessels become more vulnerable to damage. Over time, this chronic stress quietly accelerates heart disease and weakens the immune system. In other words, isolation and loneliness get under the skin and damage the heart.

Treating connection as a vital sign

Social connection is important both for prevention and treatment. Yet most medical visits still focus on cholesterol numbers, blood pressure readings, and medication lists, despite the fact that screening for social isolation is recommended and we have evidence-based, brief screening tools to assess social isolation.

We rarely ask patients a simple but powerful question: Who do you talk to when you are having a hard day?

Social connection is treated as a “nice to have,” instead of as a medical necessity. This is unfortunate since interactions with hospitals and clinics may represent the only opportunity to identify individuals who are the most isolated and lonely.

This Valentine’s Day, we should treat connection the way we treat blood pressure, cholesterol, and blood sugar, as a vital sign of health.

For clinicians, that means routinely asking patients about their social connections, recognizing isolation as a cardiovascular risk factor, and helping patients find meaningful ways to stay engaged, whether through family, community programs, faith spaces, or in-person care when virtual visits fall short.

For patients, it means giving yourself permission to prioritize connection as part of your health plan: Reaching out, rebuilding routines that include other people, accepting support, and telling your doctor when loneliness is affecting your well-being.

And for all of us, it means learning to notice when someone around us may be quietly isolated, such as the neighbor who rarely leaves home, the coworker who has grown withdrawn, the older relative whose world has gotten smaller since retirement or bereavement, and choosing to reach out rather than assume someone else will.

Love, in its many forms, protects the heart. This Valentine’s Day, love doesn’t have to look like roses, chocolates, or fancy dinners. It can look like a phone call, walking with a friend, or simply showing up. When doctors, patients, families, and communities intentionally build connection, we are not just treating disease, we are strengthening hearts and saving lives.

Crystal W. Cené is a physician executive.