Heart failure depression symptoms reduced by exercise

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Moderate exercise helps ease depression in patients with chronic heart failure, and is also associated with a small but significant reduction in deaths and hospitalizations.

“We do not know what comes first ? heart disease or depression ? but we do know the two are often related, and if depression gets worse, people have worse outcomes,” said James A. Blumenthal, PhD, professor of psychiatry and behavioral sciences at Duke and lead author of the study.

Exercise has been shown to be safe for people with heart disease, and it also improves depression. These data show the combined benefits of exercise for this population include improved mental health and improved cardio-vascular health.

Clinical depression may affect as many as 40 percent of the 5 million people in the United States with heart failure. Recent studies have linked depression with worse clinical outcomes for patients with myocardial infarction, unstable angina, coronary bypass surgery and heart failure.

In the current study, Blumenthal and colleagues set out to determine whether exercise would reduce depressive symptoms and improve other clinical outcomes among patients with heart failure.

As part of the HF-ACTION trial sponsored by the National Heart, Lung and Blood Institute, the researchers enrolled 2,322 patients at 82 medical centers in the United States, Canada and France.

All patients underwent an initial physical stress test and filled out a questionnaire that measured depressive symptoms such as feelings of sadness, irritability, hopelessness and disturbed sleep.

The patients who participated in treadmill or stationary bike workouts showed greater improvement of their cardio-pulmonary function, as measured by peak oxygen consumption and longer duration of exercise, than patients who received usual care. Small improvements accrued at both three months and 12 months.

Depression scores were also better for participants in the exercise group compared to those who received standard care.

Exercise also made a small but notable difference in the risk for hospitalizations and death over the study’s follow-up period of an average of 2.5 years.

“This study shows that exercise is associated not only with physical health benefits, but important mental health benefits as well,” Blumenthal said.

Source: Duke University Medical Center, USA


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