Exercise is beneficial for both your heart and your mood. For those with depression, the positive impact of physical activity in preventing heart attacks and strokes may be even more significant.
Key Points to Remember:
- Chronic stress and depression can lead to inflammation in the arteries, raising the risk of heart disease.
- Exercise lowers the risk of heart attacks and strokes by reducing stress and inflammation in the body.
- People with depression gain twice the heart-protective benefits from exercise compared to those without the condition.
A study published on April 15 in the Journal of the American College of Cardiology found that regular exercise can help lower the risk of heart disease, partly by aiding the brain in stress management.
Researchers found that the heart-protective benefits of physical activity nearly doubled in people with a history of depression. “Exercise was more than twice as potent at reducing heart attacks and strokes among individuals with a history of depression,” senior author Ahmed Tawakol, MD, said. He’s a researcher and cardiologist in the Cardiovascular Imaging Research Center at Massachusetts General Hospital in Boston. The impact exercise has brings when it comes to the brain’s stress-related activity may be behind this new finding, Dr. Tawakol added.
Chronic Stress Has a Damaging Impact on Heart Health Similar to Smoking or High Blood Pressure
There is substantial evidence indicating that chronic stress, stemming from sources like an unsatisfying job, financial difficulties, or troubled relationships, can be as harmful to your heart as smoking, high blood pressure, or type 2 diabetes.
The root of this issue lies in a part of your brain called the amygdala, which acts as your body’s alarm system. When you encounter stress, whether from preparing for a major presentation or dealing with a constantly barking neighbor’s dog, the amygdala springs into action.
Chronic anxiety and depression can have a similar impact. Research has demonstrated that the level of stress-related activity in the brain can be a strong predictor of the risk and timing of future heart attacks and strokes, even when other risk factors are taken into account.
The reason behind this is that a perpetually alert amygdala sends distress signals throughout the body. These signals can provoke inflammation in the arteries, which are responsible for transporting blood to the heart. Over time, this inflammation can result in serious cardiovascular issues, including heart attacks and strokes.
Strive to Achieve the Recommended Amount of Physical Activity to Lower Risk of Heart Attack and Stroke by 23%
To gain a deeper understanding of how physical activity influences stress-related brain activity and its subsequent effect on heart disease risk, researchers conducted a comprehensive analysis. They examined the medical records and additional data of 50,359 participants from the Mass General Brigham Biobank, all of whom had completed a physical activity survey. Within this group, a subset of 774 individuals also underwent brain imaging tests to measure stress-related brain activity.
The study tracked participants over a median period of 10 years, during which nearly 13 percent developed cardiovascular disease. Findings revealed that participants adhering to physical activity guidelines—engaging in at least 150 minutes of moderate exercise or 75 minutes of vigorous activity per week—had a 23 percent lower risk of developing cardiovascular disease compared to those who did not meet these exercise recommendations. This underscores the significant protective effect of regular physical activity against heart disease, highlighting its crucial role in mitigating stress-related brain activity and promoting cardiovascular health.
“In the participants without depression, reductions in heart attack risk plateaued at around 300 minutes of moderate intensity exercise per week. That observation has been seen over and over and over in the literature,” Tawakol said.
He explains that this is the reason current physical activity guidelines recommend 150 to 300 minutes of moderate-intensity exercise per week to achieve the best reductions in heart attack risk.
Physical Activity Lowers Heart Attack and Stroke Risk through Stress Management in the Brain
According to Tawakol, about 10 percent of physical activity’s cardiovascular benefits can be attributed to reductions in stress-related brain signaling. The majority of these heart health benefits, however, come from strengthening the heart, improving its efficiency, and increasing the amount of blood circulating throughout the body.
The positive changes in stress-related brain activity could be due to reduced activity in the amygdala or increased activity in the prefrontal cortex, Tawakol explains. He compares the amygdala to a gas pedal for stress hormones and the prefrontal cortex to the brakes. When you experience stress, the gas pedal (amygdala) gets pushed down, ramping up your body’s fight-or-flight response. The brake (prefrontal cortex) helps you ease off the gas, mitigating the stress response. This balance between the amygdala and prefrontal cortex plays a crucial role in managing stress and, consequently, supporting heart health.
“In other words, exercise is driving up cortical activity while driving down amygdala activity,” Tawakol said.
Ideally, maintaining a healthy balance between the amygdala and prefrontal cortex results in lower levels of stress-related brain activity, even during stressful situations.
This led researchers to their next question: Is this effect even more pronounced in people with chronic stress or depression? Tawakol explains that if exercise helps heart health by regulating stress-related brain activity, the benefits should be even greater for individuals experiencing higher levels of stress.
Exercise Provides Twice as Much Heart Protection for Depression
Although researchers anticipated greater benefits for individuals with preexisting depression, they were surprised to find that exercise provided double the protection against heart attacks and strokes for these individuals. “It was really substantial in these individuals,” Tawakol notes.
The study also uncovered another key difference: for people without depression, the heart benefits of exercise plateaued at 300 minutes per week. In contrast, there was no such plateau for people with depression. For this group, additional exercise beyond 300 minutes continued to yield further gains in heart health. Tawakol suggests that this could be because individuals with chronic stress or preexisting depression typically have a higher baseline level of stress-related brain activity. Consequently, they may experience more significant benefits from extended physical activity, which helps to further mitigate their elevated stress levels.
“These findings suggest that physical activity could be especially helpful for cardiovascular risk management in people with a history of depression, and those with greater experiences or perceptions of life stress,” Allison E. Gaffey, PhD, an assistant professor of medicine at the Yale School of Medicine in New Haven, Connecticut, said. She was not part of the research discussed.
The authors emphasize that future studies are necessary to further investigate the relationship between physical activity, stress, and brain activity. Additionally, more research is needed to confirm that exercise is directly responsible for the reductions in risk observed in the study.
Exercise Provides Short and Long Term Benefits for the Brain
Dr. Gaffey highlighted that these findings provide additional support for more consistent screenings of stress and related psychological conditions, such as depression, as part of heart disease prevention efforts.
“For example, perhaps those with high stress or a history of depression could be given more support around engaging in regular physical activity,” she explained.
Tawakol suggests that if these findings are corroborated in further studies, it could prompt revisions to exercise guidelines for individuals with depression.
In the meantime, Tawakol advises, it’s important for people to recognize that physical activity can exert significant effects on the brain, potentially offering enhanced heart benefits for those with stress-related conditions like depression.
Understanding these additional advantages may serve as a motivating factor for individuals to engage in more physical activity, as they gain a clearer understanding of the benefits they stand to gain, both immediately and over the long term.
“You’re feeling better because you have your endorphins that are a ‘flash in the pan’ — you enjoy that while you’re exercising. But physical activity is also structurally changing your brain, which is associated with even more heart-protective benefits,” Tawakol stated.
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