Exercise confers greater benefits in anxiety, depression

The cardioprotective effects of exercise are nearly twice as large in people with anxiety and depression than in those without, suggests a new study presented at ACC.22.

“We’re not suggesting though that exercise is only effective in individuals with anxiety and depression,” said study investigator Dr Hadil Zureigat, a clinical research fellow at Massachusetts General Hospital and Harvard Medical School in Boston, Massachusetts, US  in a press briefing prior to her presentation.

“What we’ve demonstrated here was people with anxiety and depression derived greater cardiovascular [CV] benefits from exercise, roughly double the risk reduction,” she added.

Coronary MACE lower

Over 50,000 adults with or without CVD or risk factors, who were enrolled in the Mass General Brigham Biobank, were followed for a median of 1.8 years. Of these, 16,995 patients had anxiety; 14,015 had depression. Up to 48 percent had CV risk factors (type 2 diabetes, hypertension, hyperlipidaemia, or current or past smoking). [ACC.22, abstract 1007-005]

There was a 17-percent lower risk of having coronary major adverse cardiovascular events (MACE) – defined as unstable angina, myocardial infarction (MI), or coronary revascularization – among individuals who met the American Heart Association (AHA)/American College of Cardiology (ACC) recommendations for physical activity (at least 150 minutes of moderate physical activity weekly).

In those with anxiety or depression, the risk of coronary MACE was 22 percent lower compared with 10 percent in individuals without the conditions, a finding the researchers said was important.

Anxiety and depression are prevalent in patients with CVD, which is the leading cause of death among men and women globally. Zureigat said their findings support lifestyle modification as an effective vehicle for CVD prevention.

How does exercise help?

Regular exercise activates the release of endorphins or feel-good brain chemicals, which enhance a sense of well-being in those with depression or anxiety.

To bolster this point, Zureigat cited a recent study showing that exercise decreased stress-associated neural activity predominantly by upregulating regulatory medial prefrontal cortical activity. “This neural effect partially mediates the beneficial impact of exercise,” she pointed out. “Not only will physical activity help patients to feel better, it will also potentially reduce their CVD risk.”

Transitioning to physical activity can be a difficult decision. But once achieved, those with chronic stress-related psychiatric conditions could “hit two birds with one stone,” Zureigat said with conviction.

On questions about exercise duration, she said any amount of exercise is helpful to lower CVD risk, particularly in those with depression or anxiety.