In a study presented at the American College of Cardiology’s 71st Annual Scientific Session in April, researchers found that regular physical activity had nearly doubled the cardiovascular benefit in individuals with depression or anxiety, compared with individuals without those diagnoses. According to the research, people who accomplished the recommended amount of physical activity per week (150 minutes) were 17 percent less likely to suffer a major adverse cardiovascular event than those who exercised less. Out of the people who achieved the recommended amount of 150 minutes per week, those with anxiety or depression had a 22 percent risk reduction versus a 10 percent risk in those without either condition. The analysis included more than 50,000 patients in the Massachusetts General Brigham Biobank database. Just over 4,000 of the patients analyzed had suffered a major cardiovascular event, like a heart attack, chest pain caused by a blocked artery, or underwent a procedure to open a blocked artery in the heart. In conducting the study, researchers initially assessed the rates of major coronary events among patients who reported in the questionnaire that they exercised at least 500 metabolic equivalent (MET) minutes per week — which aligns with the ACC’s and American Heart Association’s primary prevention guidelines of 150 minutes of moderate intensity exercise per week — with those who exercised less. Over the course of the study, researchers found that patients with depression derived more than double the benefit in exercise in terms of reduced cardiovascular risk compared with people who did not have depression. A similar benefit was found for people with anxiety. Hadil Zureigat, MD, who is the postdoctoral clinical research at Massachusetts General Hospital in Boston and the study’s lead author, clarified in the press release that the study does not suggest that exercise is only effective in those with depression or anxiety, but emphasizes that physical activity can help people feel better and potentially reduce their risk of cardiovascular disease, allowing those with common chronic stress-related psychiatric conditions to hit two birds with one stone. Michael Emery, MD, who is the co-director of the Sports Cardiology Center at Cleveland Clinic in Ohio, and was not involved in the study, explains the reason physical activity is so beneficial. “Exercise is medicine both physically and psychologically, and these factors interplay such that when you are more physically healthy your psychological state is more robust, and when you are mentally more healthy your physical state is improved,” he says. “This latter connection is both direct, the connection between hormonal stress levels and the physical state; and indirect, better healthy habits such as eating.” Rates of both depression and anxiety have risen over the COVID-19 pandemic. Eleven percent of U.S. adults surveyed in the Centers for Disease Control and Prevention’s (CDC) 2019 National Health Interview Survey had symptoms of anxiety or depression. But by December 2020, the percentage of adults showing symptoms of anxiety disorder or depressive disorder spiked to 42 percent, according to estimates from the CDC’s Household Pulse Survey. Although the survey shows that the number dropped to 31 percent by December 2021, it still remains above pre-pandemic levels. In addition, heart disease remains the leading cause of death in the United States. Researchers of the current study say the data emphasizes the important role of exercise in maintaining heart health and reducing stress. “I see way more patients in my clinics now than I did in the past,” Dr. Emery says. “They may not have overt cardiac disease, but they are very stressed about the overall pandemic, the role the pandemic has played on their health, and that is ultimately negatively impacting their health.”
A Little Bit of Physical Activity Goes a Long Way
The analysis expands upon previous studies by the research team that used brain imaging to determine how exercise improves cardiovascular health by helping to keep the brain’s stress response in check. Although this particular study used 500 MET minutes as a cutoff for the analysis, previous studies show people can reduce their risk for heart disease even if they do not achieve the recommended amount of physical activity. Emery says exercising is not just something he preaches to his patients, but something he practices. “I see it in my own personal health,” he says, noting that he has a very stressful job. “Exercise for me is what keeps the stress at bay.” Emery stresses the importance of physical activity even if it doesn’t hit the sweet spot of 150 minutes of moderate intensity exercise a week. He says taking the stairs, walking an extra bit from the car, or developing a community to help support your physical fitness needs is a great start.
