“Physical activity is a very well-established means of decreasing cardiovascular risk. But it’s also widely advocated as a means of decreasing stress,” says Hadil Zureigat, M.D., lead study author and postdoctoral clinical research fellow at Massachusetts General Hospital. “We all know how good it feels to go for a walk or a run.” So she and colleagues asked the question: Is this effect particularly salient for folks with higher stress-related activity in the brain — namely, folks with anxiety and/or depression? Zureigat and colleagues started by analyzing the health records of more than 50,000 patients in the Massachusetts General Brigham Biobank database. About 8% (4,000) had already suffered a major adverse cardiovascular event, such as a heart attack or chest pain caused by a blocked artery. Overall, researchers found that people who reported regularly completing the recommended amount of exercise per week were 17% less likely to experience a major adverse cardiovascular event. Of those who did not have mental health symptoms, regular exercise was associated with a 10% reduction in risk of such an event. For those who had anxiety and/or depression, the risk reduction associated with exercise was significantly greater, at 22%. According to 2019 guidelines from the American College of Cardiology and American Heart Association Task Force, adults should be getting at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity per week. Activities such as brisk walking, mowing the lawn, or heavy cleaning around the house count as “moderate.” Exercises like hiking, jogging, or playing a pickup basketball game are “vigorous.” The study also offers a look into how exercise promotes cardiovascular health. Based on the neuroscience, Zureigat says, it’s partly about activation of areas of the brain that help us cope with stress. Zureigat and colleagues’ past research had shown that the more you exercise, the lower the stress-related neural activity in the brain. Brain-related changes account for about 7% of the total cardiovascular benefit of exercise, Zureigat says. “Stress is really bad for health, especially for cardiovascular health,” she says. “The higher the activity in those stress regions, the higher the likelihood that you develop a cardiovascular event.” Heart disease is the leading cause of death in the U.S. With mental health crises on the rise, paired with institutional, cultural, and systemic barriers to mental health care, this study highlights an important link between two major health issues. But it also underscores a tangible solution: exercise. Even if you don’t meet the 150/75 recommendation, experts say that some physical activity is better than none. According to recommendations from the U.S. Department of Health and Human Services, “Adults who sit less and do any amount of moderate-to-vigorous physical activity gain some health benefits.” But there’s a caveat here. Even though heart health benefits of exercise increase in folks with anxiety and/or depression, those are exactly the folks who might have a particularly hard time starting to exercise regularly. “Getting into the habit of exercise is pretty tough, and having depression or anxiety probably makes it more difficult,” Zureigat says. Yet this study suggests that folks struggling with mental health who exercise will not only relieve symptoms, she says, “but they’ll be deriving double the benefit.”
