dogs, pets, longer life after heart attack or stroke

Having a Dog Linked to Longer Life After Heart Attack or Stroke Interview with:
Mwenya Mubanga, MD, PhD
Postdoctoral Researcher
Department of Medical Epidemiology and Biostatistics  | Karolinska Institutet
Childhood Allergy and Asthma
Stockholm What is the background for this study?

Response: In a previous study we showed that dog ownership was associated with a lower risk of composite cardiovascular death and all-cause death as compared to non-dog owners.1 In this follow-up, we assessed the hypothesis that dog ownership was associated with better survival after either an acute myocardial infarction or an ischemic stroke.

Using the rich Swedish national registers, we identified more than 300,000 adults aged 45 to 80 and linked their individual-level health records to information on socio-economic, demographic and death data. What are the main findings? 

Response: Utilizing both time-to-event analyses and logistic regression analyses (with all-cause death and recurrent admissions as outcomes), it was found that the risk of death was lower in dog owners than in non-dog owners for both myocardial infarction and ischemic stroke patients. The risk was much lower for individuals who lived alone than for those living with people in the household.

Dog ownership was also associated with lower risk of recurrent myocardial infarction or ischemic stroke 30 days or later after an initial event. The better outcomes appeared unbiased by either socioeconomic status or comorbidity.

There was also overlap between some of the breeds associated with better outcomes. These included Sheep and Cattle breeds, Spitz and Primitive types, Terriers, Retrievers, Scent Hounds and related dogs. These dog breeds generally require more physical activity. What should readers take away from your report?

Response: This is a register-based study that has given us significant insight to differences in health outcomes associated with dog ownership, however, it did not show the mechanisms underlying these observations. Some likely explanations include dogs provide an incentive for recovering owners to achieve regular exercise. This is important during times when the individual would probably feel less inclined to leave their homes, such as just after an illness, during winter or rainier times of the year. Regular exercise is beneficial not only in aiding recovery from cardiovascular disease but also in preventing other non-communicable diseases. In addition, regular physical activity may help detect cardiovascular disease earlier and thus dog owners may also visit health facilities earlier.

Furthermore, dog ownership is independently associated with psychosocial advantages. Social isolation, depression and loneliness are all risk factors for myocardial infarction and ischemic stroke and also worsen outcomes,2-4 and having a dog has been shown to alleviate these risk factors by providing a substitutive relationship and also allowing people to meet other dog lovers, particularly in urban settings.

Dog ownership legislation in Sweden provides detailed guidance for recommended daily pet exercise, nutrition and living space amongst others; the level of compliance to these regulations is generally high due to a high level of social and institutional trust. What recommendations do you have for future research as a result of this work?

Response: Whilst Dog ownership appears beneficial in our study, we are unable to distinguish if these outcomes are similar in dog lovers and non-dog lovers who are forced to acquire a dog.

Further, since dog ownership cannot be randomly assigned to people, it would be interesting to understand what determines pet choice and also the breed.

It would also be interesting to have activity tracking devices that measure the amount of physical activity obtained by dog owners versus non-owners, and to see to what extent this differs. Is there anything else you would like to add? 

Response: Dr Ingelsson is a scientific advisor for Precision Wellness and Olink Proteomics for work unrelated to the present project. The other authors report no conflicts.


  1. Mubanga M, Byberg L, Nowak C, Egenvall A, Magnusson PK, Ingelsson E and Fall T. Dog ownership and the risk of cardiovascular disease and death – a nationwide cohort study. Sci Rep. 2017;7:15821.
  2. Hakulinen C, Pulkki-Råback L, Virtanen M, Jokela M, Kivimäki M and Elovainio M. Social isolation and loneliness as risk factors for myocardial infarction, stroke and mortality: UK Biobank cohort study of 479 054 men and women. Heart. 2018;104:1536-1542.
  3. van Melle JP, de Jonge P, Spijkerman TA, Tijssen JGP, Ormel J, van Veldhuisen DJ, van den Brink RHS and van den Berg MP. Prognostic Association of Depression Following Myocardial Infarction With Mortality and Cardiovascular Events: A Meta-analysis. Psychosomatic Medicine. 2004;66:814-822.
  4. Krause-Parello CA. Pet Ownership and Older Women: The Relationships Among Loneliness, Pet Attachment Support, Human Social Support, and Depressed Mood. Geriatric Nursing. 2012;33:194-203.


Mwenya Mubanga, Liisa Byberg, Agneta Egenvall, Erik Ingelsson, Tove Fall. Dog Ownership and Survival After a Major Cardiovascular Event. Circulation: Cardiovascular Quality and Outcomes, 2019; 12 (10) DOI: 10.1161/CIRCOUTCOMES.118.005342

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Last Updated on October 22, 2019 by Marie Benz MD FAAD