Aims <p>Social isolation and loneliness are associated with increased risk of cardiovascular disease (CVD). Most research examining the effects of social isolation and loneliness on CVD is based in Western countries. This study examined the effects of loneliness and social isolation on cardiovascular disease in China.</p> Methods <p>Data were derived from the China Health and Retirement Longitudinal Study (CHARLS). Social isolation, loneliness and CVD were measured at baseline. The analytical sample size was 6,860 for the analysis of self-reported CVD. Cox proportional-hazard regression adjusted for confounding factors were used to assess the association between baseline isolation, loneliness, and CVD.</p> Results <p>Incident CVD was followed-up from 2011 to 2018. During the 7 years of follow-up, we found that loneliness was associated with an increased risk of CVD events (adjusted HR, 1.24; 95% CI, 1.06–1.44). In the moderately isolated group, loneliness was significantly associated with an elevated risk of incident CVD after adjusting for all confounders (adjusted HR, 1.40; 95% CI, 1.13–1.73). Loneliness was significantly associated with an increased risk of incident CVD among female participants (adjusted HR, 1.29; 95% CI, 1.07–1.56).</p> Conclusions <p>Loneliness significantly increased the risk of incident CVD, while social isolation did not exhibit a similar correlation. Our findings suggest that targeted and practical social interventions could improve the accuracy and efficiency of identifying individuals at high risk.</p>