People with depression gain most CV benefits from physical activity

Individuals who engage in physical activities (PA) enjoy a reduced risk of cardiovascular disease (CVD), especially those suffering from depression, with a recent study showing that PA acts through the brain’s stress-related activity.

“[T]his may explain the novel observation that PA reduces CVD risk to a greater extent among individuals with depression,” the authors said.

This study assessed participants from the Mass General Brigham Biobank who completed a PA survey. A subgroup of participants underwent ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomographic imaging. The authors then measured stress-related neural activity as the ratio of resting amygdalar-to-cortical activity (AmygA_C). They determined CVD events using electronic health records.

Overall, 50,359 adults (median age 60 years, 40.1 percent male) were analysed. In multivariate models, those with higher PA showed a lower AmygA_C (standardized β, ‒0.245, 95 percent confidence interval [CI], ‒0.444 to ‒0.046; p=0.016) and fewer CVD events (hazard ratio [HR], 0.802, 95 percent CI, 0.719‒0.896; p<0.001).

Reductions in AmygA_C partially facilitated the CVD benefit derived from PA (odds ratio, 0.96, 95 percent CI, 0.92‒0.99; p<0.05).

Notably, the benefit of PA on incident CVD events was more pronounced among individuals with pre-existing depression than those without (HR, 0.860, 95 percent CI, 0.810‒0.915 vs 0.929, 95 percent CI, 0.910‒0.949; p=0.011 for interaction).

“Additionally, PA above guideline recommendations further reduced CVD events, but only among those with pre-existing depression (p=0.023 for interaction),” the authors said.