People with anxiety, depression may reap more cardiovascular benefits from exercise, study finds

People with anxiety or depression reap double the cardiovascular benefit from regular exercise than others, according to new data.

The researchers say that their findings confirm what previous research has suggested – that physical activity improves cardiovascular health by helping to activate parts of the brain that counteract stress.

Across the board, researchers found people who exercise at least 150 minutes a week were 17% less likely to suffer a major cardiovascular event than those who exercised less. 

But there was a sizable disparity between people with anxiety or depression and those without the mental health conditions. The risk reduction was 22% for people with anxiety or depression; it was just 10% for those without them. 

“The effect of physical activity on the brain’s stress response may be particularly relevant in those with stress-related psychiatric conditions,” said researcher Dr. Hadil Zureigat, postdoctoral clinical research fellow at Massachusetts General Hospital in Boston.

“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.”

Previous research conducted by Zureigat suggested exercise helps keep the brain’s stress response in check, which in turn improves cardiovascular health. This is especially important for people with depression and anxiety, because they have higher stress-related neural activity and a higher risk of cardiovascular disease.

So what exactly is the connection between stress and the heart?

Stress is a known risk factor for heart disease. It can increase inflammation in the body, raising blood pressure and lowering “good” high-density lipoprotein cholesterol.

Chronic stress also leads to negative lifestyle changes such as eating more junk food, poor sleep habits and exercising less – all factors that also put the heart at risk.

“When one thinks about physical activity decreasing cardiovascular risk, one doesn’t usually think of the brain,” Zureigat said. “Our research emphasizes the importance of the stress-related neural mechanisms by which physical activity acts to reduce cardiovascular risk.”

Their findings, based on the health records of 50,000 people, emphasize the important role exercise plays in maintaining heart health and reducing stress, the researchers say.

“Any amount of exercise is helpful, particularly for those with depression or anxiety,” Zureigat said. “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.”

Both rates of depression and anxiety have increased during the COVID-19 pandemic, and heart disease remains the leading cause of death in the U.S.

One study conducted by the U.S. Centers for Disease Control and Prevention in 2020 found that 30.9% of American adults had an anxiety or depressive disorder related to the pandemic. The numbers were even higher among adults ages 18-24. About 63% of them reported anxiety or depressive symptoms.

According to the Mayo Clinic, exercise also can help improve the symptoms of depression and anxiety. The release of feel-good endorphins and other brain chemicals can enhance the sense of well-being and reduce negative thoughts common in these conditions. Other benefits include confidence-building and an increase in social interaction.

In Zureigat’s study, a little more than 4,000 of the patients experienced a major adverse cardiovascular event, which included a heart attack, chest pain caused by a blocked artery or undergoing a procedure to open a blocked artery in the heart.

The researchers used a questionnaire to assess the rates of major coronary events among patients who exercised at least 150 minutes per week – the amount of physical activity recommended by the American College of Cardiology and American Heart Association.

They then dug further to see whether the cardiovascular benefits of exercise differed among people with anxiety or depression.