Regular exercise yields greater CV benefit in adults with anxiety, depression
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WASHINGTON — For adults with anxiety or depression, regular exercise had nearly double the CV benefit compared with those without these diagnoses, researchers reported at the American College of Cardiology Scientific Session.
“Our findings are not meant to suggest that exercise is only good or has CV benefit in those with [anxiety and/or depression], but it does suggest that people with stress-related conditions tend to derive a greater benefit,” Hadil Zureigat, MD, postdoctoral clinical research fellow at Massachusetts General Hospital, said during an ACC press conference. “It also emphasizes stress-related neural pathways in explaining part of the CV benefit of exercise.”
Zureigat and colleagues analyzed health records of 50,359 adults (mean age, 59 years) in the Mass General Brigham Biobank database. More than 4,000 developed a major adverse CV event, including MI, coronary revascularization or unstable angina, during a median of 1.8 years.
The researchers assessed rates of major adverse CV events among participants who self-reported physical activity for at least 500 metabolic equivalent (MET) minutes per week, which is aligned with current guideline recommendations for physical activity, compared with those who exercised less than 500 MET minutes per week.
Those who reported greater exercise were 17% less likely to have a major adverse CV event, according to the results.
Further, the researchers then assessed rates of major adverse CV events and exercise in participants with a diagnosis of depression or anxiety compared with participants without these diagnoses.
“People with either diagnosis actually derived double the CV benefit from exercise compared with those without the diagnoses,” Zureigat said.
The CV benefits of regular exercise were significantly greater in participants with anxiety or depression, who had a 22% risk reduction for a major adverse CV event compared with a 10% risk reduction for those without either diagnosis, according to the results.
The findings suggest that exercise improves CV health by activating parts of the brain that counteract stress. The decrease in stress-related neural activity was “significant and dose-dependent” with higher levels of physical activity, Zureigat said.
“It is important to note how common anxiety and depression are in our patients,” said press conference moderator Katie Berlacher, MD, MS, FACC, the incoming ACC Scientific Session vice chair, assistant professor of medicine at University of Pittsburgh Medical Center (UPMC), and associate chief of cardiology for education and program director of the cardiology fellowship program at UPMC Heart and Vascular Institute. Other research has demonstrated that patients with CVD who also have untreated anxiety and depression do worse from a CV standpoint, and if their anxiety and depression are treated they have improved outcomes, according to Berlacher.
A limitation of the study is that physical activity was self-reported by participants and type of physical activity — for example, strength or high-intensity interval — is unknown.
“I find [this study] incredibly fascinating and really uplifting that this is something we can offer our patients that’s not a pill,” Berlacher said, adding that exercise, not always but often, can be free.
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Zureigat H, et al. Abstract 1007-05. Presented at: American College of Cardiology Scientific Session; April 2-4, 2022; Washington, D.C. (hybrid meeting).
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