Effect of Stress-Related Neural Pathways on the Cardiovascular Benefit of Physical Activity
Authors' conclusion
PA appears to reduce CVD risk in part by acting through the brain's stress-related activity; this may explain the novel observation that PA reduces CVD risk to a greater extent among individuals with depression.
Study context
- Population
- Adults in the Mass General Brigham Biobank who completed a physical activity (PA) survey
- Participants
- 50,359 adults
- Exposure
- Greater vs lower PA
- Outcome
- Stress-related neural activity (AmygAC) and CVD events, by greater PA
Methodological detailsbiobank, subset with 18F-FDG PET/CT imaging, multivariable models
- Biobank
- Subset with 18F-FDG PET/CT imaging
- Multivariable models
Main finding
As reported in the abstract
Estimate (95% CI)P value
Greater PACVD events; multivariable
HR 0.802(0.719–0.896)
P < 0.001AmygAC reductionspartial mediation of PA's CVD benefit
OR 0.96(0.92–0.99)
P < 0.05- Greater PA · AmygAC; multivariable
- standardized β −0.245 (95% CI −0.444 to −0.046); P = 0.016
Observational data: associations, not effects.
Further findings
Incident cardiovascular disease (CVD) events, by preexisting depression (subgroup)
| HR (95% CI) | ||
|---|---|---|
| Greater PAWith depression | 0.860 (0.810–0.915) | |
| Greater PAWithout depression | 0.929 (0.910–0.949) | |
| 0.512Hazard ratio (log scale) |
- Incident CVD events, by preexisting depression (subgroup): P interaction = 0.011
PA above guideline recommendations and CVD events, by preexisting depression
- Further reduced CVD events only among those with preexisting depression
- P interaction = 0.023
Original publication
Effect of Stress-Related Neural Pathways on the Cardiovascular Benefit of Physical Activity. J Am Coll Cardiol. Published 23 April 2024. doi:10.
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