Exercise may lower heart disease risk in depressed people

Health column

Islamabad - Exercise may reduce the chances of developing heart disease for people with depression, a new study suggests.
Depressed people who weren’t physically active had stiffer and more inflamed aortas — the large artery carrying blood from the heart — two signs of heart disease. But, in depressed people who exercised, aortic stiffening and inflammation were less common, the study authors found.
“Depression and physical inactivity have been shown to be associated with increased risk of cardiovascular events,” said Dr Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, who reviewed the study’s findings.
“Although associations [in the study] were found between depression and artery function, which was improved in people who exercise regularly, additional studies are needed before we can conclude that exercise reduces heart disease risk in those with depression,” he said.
The new study wasn’t designed to prove a cause-and-effect relationship.
Depression has previously been linked to a higher risk of heart disease and other physical problems. In addition, depression has been linked to worse outcomes for people with heart disease and other conditions, the study authors said. As many as 20 percent of people hospitalized with a heart attack are depressed, the researchers pointed out. And, patients with heart disease have three times the risk of developing depression compared with the general population, the study authors said.
For the new study, a team led by Dr. Arshed Quyyumi, co-director of the Emory Clinical Cardiovascular Research Institute at Emory University in Atlanta, recruited nearly 1,000 people. The mean age of study volunteers was 49 years. About one-third of the participants were male, and 39 percent were black. All of the study volunteers were free of heart disease at the start of the trial. In addition, they hadn’t been diagnosed with a mental health condition.
The study participants completed questionnaires on depression and physical activity. The researchers also checked for several early indicators of heart disease. According to Quyyumi, the study findings highlight the link between depression and heart disease risk.
“This research also demonstrates the positive effects of exercise for all patients, including those with depressive symptoms,” Quyyumi said in a journal news release.
However, whether exercise will reduce depression and lower the risk of bad outcomes among those with heart disease isn’t known, Quyyumi said. Samantha Heller is an exercise physiologist at New York University Medical Center in New York City. She said the “human body is one big chemistry lab that not only governs our health, but also our mental and emotional states.” Heart disease may be the result of lifestyle, environment, genetics and age, she said. And, all of these can have an impact on our psychological well-being, Heller added.
The effects of heart disease on our psychological well-being may have several points of origin, she explained. For example, increased inflammation and limited blood flow could have indirect or direct biochemical and mechanical effects on the brain.
“The human body is designed both physically and biochemically to move,” she said.
“When we exercise these systems jump into gear to adapt to the challenges presented, such as increasing stamina, strengthening muscles and bones, improving mood and reducing anxiety,” Heller said.
Surprising implications of stress
for health
Whether it is down to work pressure, money worries or relationship troubles, most of us experience stress at some point in our lives. In fact, around 75% of us report experiencing moderate to high levels of stress over the past month. It is well known that stress can cause sleep problems, headache and raise the risk of depression. But in this Spotlight, we look at some of the more surprising ways in which stress may harm our health.
Over the past month, around 75% of us have experienced moderate to high levels of stress.
The National Institute of Mental Health (NIMH) define stress as the “brain’s response to any demand.” In other words, it is how the brain reacts to certain situations or events.
It is important to note that not all stress is negative. Many of us who have been in a pressurized situation may have found that stress has pushed us to perform better. This is down to a “fight-or-flight” response, whereby the brain identifies a real threat and quickly releases hormones that encourage us to protect ourselves from perceived harm. It is when this fight-or-flight response overreacts that problems arise, and this usually happens when we find ourselves exposed to constant threats.
“Stress is caused by the loss or threat of loss of the personal, social and material resources that are primary to us. So, threat to self, threat to self-esteem, threat to income, threat to employment and threat to our family or our health,” Stevan Hobfoll, PhD, the Judd and Marjorie Weinberg presidential professor and chair at Rush University Medical Center in Chicago, IL, and member of the American Psychological Association (APA), told media.
In February last year, the APA released their annual “Stress in America” Survey, which assesses the attitudes and perceptions of stress and identifies its primary causes among the general public. The survey, completed by 3,068 adults in the US during August 2014, revealed that the primary cause of stress among Americans is money, with 72% of respondents reporting feeling stressed about finances at some point over the past month. Of these, 22% said they had felt “extreme stress” in the past month as a result of money worries.
The second most common cause of stress among Americans was found to be work, followed by the economy, family responsibilities and personal health concerns.
On a positive note, average stress levels among Americans have decreased since 2007. On a 10-point scale, respondents rated their stress levels as 4.9, compared with 6.2 in 2007. However, the APA say such levels remain significantly higher than the 3.7 stress rating we consider to be healthy.
“[Last] year’s survey continues to reinforce the idea that we are living with a level of stress that we consider too high,” says Norman B. Anderson, CEO and executive vice president of the APA, adding:
“All Americans, and particularly those groups that are most affected by stress - which include women, younger adults and those with lower incomes - need to address this issue sooner than later in order to better their health and well-being.”
“Stress is significantly associated with virtually all the major areas of disease,” Prof. Hobfoll told MNT. “Stress is seldom the root cause of disease, but rather interacts with our genetics and our state of our bodies in ways that accelerate disease.”
Some of the more well-known implications of stress that many of you may have experienced include sleep deprivation, headache, anxiety and depression. But increasingly, researchers are uncovering more and more ways in which stress can harm our health.
According to the American Heart Association (AHA), stress can influence behaviors that have negative implications for heart health.
Stress has also been associated with increased risk of heart attack. In 2012, a study published in The Lancet found that work stress may raise the risk of heart attack by 23%. And in February last year, MNT reported on a study by researchers from the University of Sydney in Australia, which found periods of intense anger or anxiety may raise heart attack risk by more than nine times.
Even after a heart attack, stress may continue to affect health. A study published in the journal Circulation in February 2015 found women were more likely to experience higher levels of mental stress following a heart attack, which results in poorer recovery.
Periods of stress increase production of the hormone cortisol, which can increase the amount of glucose in the blood - a potential explanation for why stress has been linked to higher risk of diabetes.

ePaper - Nawaiwaqt