Depressive Symptoms Do Not Reduce The Benefits Of Physical Activity On Recurrent Cardiovascular Disease Events

Abstract

PURPOSE: To examine prospectively whether depressive symptoms attenuate the benefits recreational physical activity on the risk of recurrent CVD in a population based sample of primary incident MI survivors. METHODS: Cases (1063 men, 430 women) 35-69 yrs old were recruited from 12 of 15 Western New York hospitals and completed an interviewer-administered survey and clinic exam (mean 4 months post-MI). Recreational physical activity (RPA) was assessed using the Stanford 7-day physical activity recall and depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). A score of ≥16 on the CES-D was used to define depression. Recurrent events (RE) included non-fatal and fatal CVD (ICD9 390-450) and revascularizations (ICD9 36-39). Age and sex-adjusted Cox regression models were used to examine the effect of depression on the association between RPA and RE. RESULTS: During a mean follow-up period of 2.4 yrs a total of 314 RE occurred. Depression was associated with an increased risk of recurrent events (HR 1.34 95%CI 1.02-1.75), whereas RPA had a protective effect on RE (HR 0.63 95%CI 0.50-0.79). The protective effect of RPA on RE remained after adjustment for age and sex (HR 0.66 95% CI: 0.52-0.83). Further adjustment for the presence of depressive symptoms did not change the association between RPA and RE (HR = 0.66, 95% CI: 0.52-0.83). CONCLUSIONS: Depressive symptoms did not reduce the protective effect of RPA on recurrent events in this population-based prospective study of MI survivors. These findings have important implications for MI survivors since depression is common in CHD patients.