Smokers suffering from depression after a heart attack have to start exercising and kick that habit, suggests a new study.
Depression is almost three times more common in people who have had a heart attack than in those who haven't, said Manuela Abreu, a psychiatrist at the University of Lisbon, Portugal, adding that cardiac rehabilitation with aerobic exercise can reduce depressive symptoms and improve cardiovascular fitness.
Patients who are depressed after a heart attack have a two-fold risk of having another heart attack or dying compared to those who are not depressed, added David Nanchen of University of Lausanne, Switzerland.
The study found that at one year, 27 percent of heart attack patients had persistent or new depression and 11percent had improved depression. Patients with depression were less frequently married, had more diabetes, and were more frequently smokers than those without depression.
At one year, smoking cessation had the strongest association with improvement of depression with a 2.3 greater chance of improving depression in quitters compared to those who continued smoking. Depressed patients who had higher physical activity at the beginning of the study were also more prone to improve their depression.
Heart attack patients who smoke and are depressed are much more likely to improve their depression if they kick the habit, said Dr Nanchen, adding while the observational study was unable to find an impact of exercise after heart attack on depressive symptoms, researchers did show that patients who were already physically active were more able to improve their depression.
Nanchen noted that they believe that the benefits of exercise after heart attack would be shown in a randomized trial, but such a study is difficult to perform for ethical reasons. Nanchen advised heart attack patients to discuss smoking cessation with their doctor and to be physically active.
"You should do moderate to vigorous aerobic exercise for 30 minutes at least three times a week to be within recommended levels. Make sure you are working hard enough to break out in a sweat," he said.