After Heart Attack, Exercise, Quitting Smoking Eases Depression

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Depression is almost three times more likely in people who have had a heart attack than in those who haven’t had one. But exercise and quitting smoking can reduce depressive symptoms.

Manuela Abreu, MD, a psychiatrist at the University of Lisbon, Portugal, and colleagues examined data from 1,164 patients who took part in the Swiss Acute Coronary Syndromes cohort. Patients enrolled between 2009 and 2013, and were followed for up to a year. Depression was measured at enrollment and at one year.

The researchers examined how managing cholesterol, blood pressure, quitting smoking, and reducing alcohol consumption after heart attack would factor in to improvement of depressive symptoms.

After one year, 27% of heart attack patients had persistent or new depression, while 11% had improved depression. Patients with depression had more diabetes, and were more frequently smokers than those without depression.

However, smoking cessation showed the strongest association with improving depression, with a 2.3 greater chance of improving depression in quitters compared to those who continued smoking, according to the researchers. And depressed patients who exercised more at the study’s outset demonstrated better improvement in their depression.

Depression in cardiac patients often differs from what is seen in psychiatric patients. “Frequently they don’t say they feel sad or hopeless, but instead complain of insomnia, fatigue, or body pain,” Abreu said in a statement. “The different clinical presentation contributes to the underdiagnosis of depression in cardiac patients.”

After Heart Attack, Exercise, Quitting Smoking Eases Depression
Smoking cessation demonstrated the strongest association with improving depression after heart attack.

A new study shows that exercise and stopping smoking will improve depression after a heart attack.

For the study, the researchers analyzed data from 1,164 patients who were part of the Swiss Acute Coronary Syndromes (ACS) cohort, a multicenter study of patients with ACS in Switzerland. Patients were enrolled between 2009 and 2013 and followed up for one year. Depression was assessed at enrollment and again at one year.

The researchers investigated the impact of a number of factors on the improvement of depression after a heart attack, including blood cholesterol management, blood pressure control, smoking cessation for smokers, reduction of alcohol for those consuming more than 14 drinks per week, intensification of physical activity, and recommended medications.

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