Suzanne Verschueren1, Anne M Eskes2, Jolanda M Maaskant3, Annelieke M Roest4, Corine H M Latour5, Wilma Scholte Op Reimer6. 1. ACHIEVE Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands. Electronic address: s.v.verschueren@gmail.com. 2. ACHIEVE Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands. Electronic address: a.m.eskes@amc.uva.nl. 3. ACHIEVE Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Medical Faculty, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: j.m.maaskant@hva.nl. 4. Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Psychology, Developmental Psychology, University of Groningen, Groningen, The Netherlands. Electronic address: a.m.roest@umcg.nl. 5. ACHIEVE Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands. Electronic address: c.h.m.latour@hva.nl. 6. ACHIEVE Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands; Department of Cardiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: w.j.m.scholte.op.reimer@hva.nl.
Abstract
OBJECTIVE: Depressive and anxiety symptoms are associated with Ischemic Heart Disease (IHD). Exercise interventions might improve both depressive and anxiety symptoms, but an overview of the evidence is lacking. Therefore, we systematically reviewed the existing literature on the effectiveness of exercise therapy to reduce depression and anxiety symptoms specifically in patients with IHD. METHODS: MEDLINE, EMBASE, PsycINFO and the Cochrane Central Register of Controlled Trials were searched until January 2016. The effectiveness of exercise was assessed within two groups: a) patients selected for study with severe depression or anxiety; and b) studies that did not exclusively targeted patients with increased levels of depression or anxiety. Secondary outcomes were mortality, cardiac events, re-hospitalizations and cardiovascular risk factors. RESULTS: We included fourteen studies. Clinical and methodological heterogeneity precluded meta-analysis. Three studies specifically included patients with high levels of depression or anxiety and eleven studies selected patients with unclear levels of depression or anxiety. Some RCTs showed that exercise was effective in lowering severe depressive symptoms (short and long term follow-up), but for the group with unclear depressive symptoms the results were non-conclusive. In the group with elevated anxiety symptoms, exercise had a positive effect on the short term follow-up. In the group with unclear anxiety symptoms the results were inconsistent (short and long term follow-up). No differences were found regarding the secondary outcomes. CONCLUSIONS: There is a general paucity of data on the effect of exercise, precluding firm conclusions about the effectiveness of exercise for depressive and anxiety symptoms in IHD patients.
OBJECTIVE:Depressive and anxiety symptoms are associated with Ischemic Heart Disease (IHD). Exercise interventions might improve both depressive and anxiety symptoms, but an overview of the evidence is lacking. Therefore, we systematically reviewed the existing literature on the effectiveness of exercise therapy to reduce depression and anxiety symptoms specifically in patients with IHD. METHODS: MEDLINE, EMBASE, PsycINFO and the Cochrane Central Register of Controlled Trials were searched until January 2016. The effectiveness of exercise was assessed within two groups: a) patients selected for study with severe depression or anxiety; and b) studies that did not exclusively targeted patients with increased levels of depression or anxiety. Secondary outcomes were mortality, cardiac events, re-hospitalizations and cardiovascular risk factors. RESULTS: We included fourteen studies. Clinical and methodological heterogeneity precluded meta-analysis. Three studies specifically included patients with high levels of depression or anxiety and eleven studies selected patients with unclear levels of depression or anxiety. Some RCTs showed that exercise was effective in lowering severe depressive symptoms (short and long term follow-up), but for the group with unclear depressive symptoms the results were non-conclusive. In the group with elevated anxiety symptoms, exercise had a positive effect on the short term follow-up. In the group with unclear anxiety symptoms the results were inconsistent (short and long term follow-up). No differences were found regarding the secondary outcomes. CONCLUSIONS: There is a general paucity of data on the effect of exercise, precluding firm conclusions about the effectiveness of exercise for depressive and anxiety symptoms in IHD patients.