Exercise helps depression in heart disease patients

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Regular exercise reduces depression in patients who suffer from heart disease, according to a study published this month in the Journal of the American Medical Association.

This is a big deal, said Srinivas Murali, director of the Division of Cardiovascular Medicine at Allegheny General Hospital, because most people who have cardiac problems are depressed about their condition, and antidepressant drugs don't seem to help.

Heart failure is the No. 1 cardiovascular cause of death. About 75 percent of people who suffer heart failure have symptoms of depression, Dr. Murali said. Up to 40 percent suffer from clinical depression.

"We've known for some time that people with heart problems who are depressed have worse outcomes," Dr. Murali said.

The study involved 2,322 patients at 82 medical centers in the U.S., Canada and France. Participants performed 90 minutes of supervised exercise per week. It was led by physicians at the Duke University Medical Center.

Their level of depression was measured on the Beck Depression Inventory II, a questionnaire on which scores range from 1 to 59. Scores of 1 to 10 are considered normal. Scores of 17 or higher signal clinical depression.

At entry, the median BDI II score for the patients in the clinical trial was 8, with 28 percent having scores of 14 (mild mood disturbance) or higher. In retests after 3 months and 12 months, those in the aerobic exercise group scored about three-fourths of a point lower than did those in the control group.

"Compared with guideline-based usual care, exercise training resulted in a modest reduction in depressive symptoms," the study concluded.

This study was ancillary to an earlier study of the same subjects that looked at the physical benefits of regular exercise for cardiac patients, Dr. Murali said. That study found a "small, but significant" improvement in survival rates for the patients who exercised.

"If you put heart failure patients through structured training, outcomes get better, depressive symptoms get better," he said. "Exercise improves their mental state as well as their physical state. This is a really important observation."

health

Jack Kelly: jkelly@post-gazette.com or 412-263-1476.


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