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Morbidity, mortality and depression reduced with exercise in HF patients
Moderate exercise has been linked to easing depression, as well as reducing deaths and hospitalizations in patients with chronic HF, according to recently published study results.
James A. Blumenthal, PhD, of Duke University Medical Center, and colleagues reported data on 2,322 patients enrolled in the HF-ACTION trial. Patients were randomly assigned to receive usual care, including necessary medications and a recommendation to exercise, or usual care plus a supervised exercise regimen, including treadmill and bicycle workouts three times a week for 30 minutes. After 3 months, the exercise group transitioned to exercising at home for another 9 months without supervision.
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 tests were repeated every 3 months for the first year. Patients were asked to make quarterly follow-up clinic visits for the second year of the study, and then annual visits through year 4 of the trial.
The patients in the exercise group showed greater improvement of their cardiopulmonary function than patients who received usual care at both 3 and 12 months.
The cardiac patients who exercised saw an average depression score decrease of 1.75 points in the first 3 months vs. patients in the usual care group, who saw a decrease of about 1 point. Sixty-six percent of those in the exercise group died or were hospitalized during the follow-up period vs. 68% of patients in the usual care group, which was significant, according to the researchers.
“These data show the combined benefits of exercise for this population include improved mental health and improved cardiovascular health,” Blumenthal said in a press release.
Disclosure: The study was funded by 13 National Heart, Lung, and Blood Institute grants.
Perspective
Back to TopEven a few symptoms of depression predict an increased risk for mortality and medical morbidity in patients with HF. For many of these patients, antidepressants are not an option, and many cardiologists have resisted even screening for depression in patients with HF because it was not clear what could be done, especially for those whose depression symptoms do not meet the level needed for a diagnosis of clinical depression. The results of this study suggest that exercise may be “just what the doctor ordered,” improving both depression symptoms and survival in these patients. What is now needed is a study to determine the effects of exercise in patients who have HF and major depressive disorder.