HealthNotes

• By Maureen Williams, ND

Exercise: Good Medicine for Matters of the Heart

Depression and heart disease often go hand in hand: depression is more common in people with cardiovascular disease, and people with depression are more vulnerable to cardiovascular events like heart attack and stroke. One study found that exercise worked at least as well as an antidepressant medication in people with both depression and cardiovascular disease, and may have the added benefit of improving heart health.

Getting enough omega-3 fats helps prevent both depression and heart disease

Treating depression in people with heart disease

The study, published in the Journal of the American College of Cardiology, included 101 sedentary adults with coronary artery disease who also had depression but were not being treated for it. They were divided into three groups that received one of three treatments:

• an aerobic exercise program in which participants walked or jogged on a treadmill at a pace set to maintain their individually determined target heart rate in three 30-minute sessions per week,
• antidepressant medication (sertraline, brand name Zoloft), 50­ to 200 mg per day depending on individual response, or,
• a placebo.

Questionnaires were used to assess depressive symptoms throughout the 16 weeks of the study, and 24-hour ECG (electrocardiogram) readings were taken at the beginning and end to monitor changes in coronary artery health.

Exercise beats antidepressants in the most depressed

At the end of the study, the following results were noted:

• Depressive symptoms improved more in people in both the exercise group and the medication group than in people in the placebo group.
• When only people diagnosed with major depressive disorders (a more severe form of depression) were considered, 40% of exercisers and 10% of medication users experienced a complete remission of their depression during the trial; there were no remissions in the placebo group.
• Results from ECG readings suggested that coronary artery disease improved more in the exercise group than in the medication and placebo groups, but the differences were not statistically significant.

“These data add to the growing body of research suggesting that exercise may be a viable alternative to traditional psychopharmacological treatments of depression,” said the study’s authors. They further emphasized the importance of their findings “in light of the growing evidence that depression is associated with increased risk of fatal and nonfatal events” in people with cardiovascular disease.

The connection between mood and heart

Exercise isn’t the only treatment that might help both depression and heart disease. Here are some other things you can do for emotional and cardiovascular health:

• Eat fish. The polyunsaturated omega-3 fats from fish have anti-inflammatory actions. Getting enough omega-3 fats helps prevent both depression and heart disease.
• Get enough D. Maintaining healthy levels of the sunshine vitamin appears to protect against an array of chronic conditions including heart disease and depression. Many experts recommend 1,000 to 2,000 IU of vitamin D per day.
• Boost your B vitamins. Low levels of folic acid and vitamins B6 and B12 can cause an increase in levels of homocysteine, an amino acid linked to both depression and heart disease. Taking 400 to 1,000 mcg of folic acid per day, 10 to 50 mg of vitamin B6 per day, and 50 to 300 mcg of vitamin B12 per day is generally enough to keep homocysteine levels down.
• Relax. Studies link relaxation practices like mindfulness meditation with better outcomes in people with cardiovascular disease. Relaxation is also good for emotional health, relieving both depression and anxiety.

(J Am Coll Cardiol 2012)