Does Exercise Combat Depression in CV Patients?
Exercise can reduce symptoms of depression in patients with cardiovascular disease, according to two separate studies published this week in the Journal of the American College of Cardiology (JACC) and The Journal of the American Medical Association (JAMA).
The JACC study, which presented findings from the UPBEAT trial, found that both exercise and medication were as effective as placebos in reducing depressive symptoms. Specifically, participants in both the aerobic exercise (mean _7.5; 95 percent confidence interval: _9.8 to _5.0) and sertraline (mean _6.1; 95 percent confidence interval: _8.4 to _3.9) groups achieved larger reductions in depressive symptoms compared with those receiving placebo (mean _4.5; 95 percent confidence interval: _7.6 to _1.5; p _ 0.034).
The study also found evidence that active treatments may improve cardiovascular biomarkers, suggesting positive quality-of-life benefits, in addition to improved clinical outcomes. "Although improvements in biomarkers do not necessarily translate into improved clinical outcomes, our finding that [heart rate variability] may be reduced in depressed cardiac patients is encouraging," the study authors said.
Authors of the JAMA study, HF-ACTION, found similar results in heart failure patients. Aerobic exercise resulted in lower mean Beck Depression Inventory II (BDI-II) scores at three months and at 12 months. Over a median follow-up period of 30 months, 68 percent of patients undergoing guideline-based usual care died or were hospitalized, compared with 66 percent of patients involved with exercise training (hazard ratio [HR],0.89; 95 percent CI, 0.81 to 0.99; P=.03).
Data from this study indicated a need to not focus on reducing depressive symptoms but on preventing worsening depression symptoms as well, the authors said. They urged further investigation into the clinical significance of these improvements. Authors of the UPBEAT study had similar recommendations, suggesting that the UPBEAT results support recommendations of routine monitoring of depressive symptoms in patients with coronary artery disease.
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