Benefits of Exercise in CVD Risk Reduction More than Double in Anxiety, Depression

ACC 2022. Exercise lowers CVD risk in part by reducing the same neurobiologic activity associated with depression and anxiety, according to study authors.

In individuals with depression or anxiety, regular physical activity nearly doubled the cardiovascular (CV) benefit seen in persons without these diagnoses.

The findings are from a new study conducted by a research team from the Massachusetts General Hospital (MGH) and presented at the American College of Cardiology’s (ACC) 71st Annual Scientific Session, held April 2-4, 2022.

Specifically, among individuals who achieved a recommended weekly amount of physical activity, the risk of a major adverse cardiovascular event (MACE) was 17% less than among those who did less exercise. The benefit of exercise was significantly greater among those diagnosed with either anxiety or depression, who experienced a 22% risk reduction of MACE vs a 10% reduction observed in those without either mental illness, according to the study abstract.

Both stress-associated neurobiologic activity and CV risk are greater in persons with anxiety and depression, the authors note in the abstract. Given the ability of exercise to reduce CV events in part by reducing this neurobiologic activity, the MGH team hypothesized, that the CV benefits from physical activity would be greater among those with anxiety and depression.

“The effect of physical activity on the brain’s stress response may be particularly relevant in those with stress-related psychiatric conditions,” said study lead author Hadil Zureigat, MD, postdoctoral clinical research fellow at Massachusetts General Hospital, in a statement from ACC. “This is not to suggest that exercise is only effective in those with depression or anxiety, but we found that these patients seem to derive a greater cardiovascular benefit from physical activity.”

The retrospective review analyzed health records from 50 359 participants with physical activity data (median age 59 years) in the Mass General Brigham Biobank. Investigators used ICD-10 codes to identify diagnoses of MACE (myocardial infarction, unstable angina, or coronary revascularization), CV risk factors (hypertension, diabetes, hyperlipidemia, current/past smoking), depression, and anxiety.

Over a median follow-up of 1.8 years, Zureigat and team identified 4003 individuals who developed MACE. They then assessed rates of major coronary events among patients who self-reported exercise of at least 500 metabolic equivalent (MET) minutes per week* and those who reported less. In models that adjusted for CV risk factors, achieving at least 500 MET-minutes or more per week was associated with lower risk for MACE (OR [95% CI]: 0.838 [0.779, 0.901], p=0.015).

The team then turned specifically to those patients diagnosed with either anxiety or depression to evaluate the association between level of exercise achieved weekly and MACE. The benefits from exercise in terms of reduced risk of MACE were greater than double for those with both depression and anxiety than for those without either (pinteraction<.05).

The investigators note that previous research has demonstrated reduced risk for CV disease at levels of exercise that do not meet current recommendations. A little bit is better than none, they assert.

“Any amount of exercise is helpful, particularly for those with depression or anxiety,” said Zureigat. “Not only will physical activity help them feel better, but they will also potently reduce their risk of cardiovascular disease. It can be hard to make the transition, but once achieved, physical activity allows those with these common chronic stress-related psychiatric conditions to hit two birds with one stone.”

Zureigat will present the study, “Cardiovascular Benefit of Exercise is Greater in Those with Anxiety and Depression,” on Saturday, April 2, at 10:00 a.m. ET / 14:00 UTC in Prevention and Health Promotion Moderated Poster Theater 4, Hall C.