Summary: Regular physical activity lowers the risk of cardiovascular disease in part by reducing stress-related signaling in the brain. In an analysis of over 50,000 adults, those who met recommended activity levels had about a 23% lower risk of developing heart disease. The protective effect was strongest among people with stress-related conditions such as depression.
Researchers attribute much of this benefit to improved function of the prefrontal cortex, a brain region that helps control stress responses. Increased prefrontal activity appears to dampen stress-related neural pathways that otherwise contribute to cardiovascular risk.
Key Facts:
- The study examined medical records, physical activity surveys, and brain imaging from 50,359 participants, finding a clear association between higher physical activity and reduced cardiovascular events.
- Participants who followed activity guidelines showed lower activity in brain regions linked to stress; these neural changes helped explain part of the reduced heart disease risk.
- The cardiovascular benefits of exercise were especially pronounced in individuals with stress-related conditions such as depression, suggesting exercise may be particularly effective for this group.
Source: Mass General
New findings show that physical activity reduces cardiovascular disease risk partly by lowering stress-linked brain activity.
Led by investigators at Massachusetts General Hospital (MGH) and published in the Journal of the American College of Cardiology, the study found that people with stress-related disorders—especially depression—gained substantial cardiovascular protection from physical activity. The work links behavioral recommendations to measurable changes in brain function and clinical outcomes.
To explore how exercise affects both mood-related neural systems and cardiovascular health, Ahmed Tawakol, MD, a cardiologist and investigator in the Cardiovascular Imaging Research Center at Massachusetts General Hospital, and colleagues analyzed data from 50,359 adults enrolled in the Mass General Brigham Biobank who completed a physical activity survey.
A nested group of 774 participants underwent brain imaging that measured stress-related neural activity. The imaging focused on activity in circuits known to drive stress responses and cardiovascular risk, including the amygdala and cortical regions.
Over a median follow-up of 10 years, 12.9% of participants experienced cardiovascular events. Those meeting recommended physical activity levels had a 23% lower risk of developing cardiovascular disease compared with participants who did not meet the recommendations.
Higher physical activity was associated with reduced stress-related brain activity. This reduction reflected stronger engagement of the prefrontal cortex, a brain area responsible for executive functions such as decision-making and impulse control that also helps restrain stress-sensitive regions. Analyses adjusted for lifestyle factors and established coronary disease risk factors.
Importantly, decreases in stress-related neural signaling accounted for part of the cardiovascular benefit seen with physical activity, indicating a mechanistic link between exercise, brain function, and heart health.
When the team examined subgroups, they found the cardiovascular benefit of exercise was substantially greater among people expected to have higher stress-related brain activity—particularly those with pre-existing depression. In this group, exercise reduced cardiovascular risk roughly twice as effectively as in people without depression.
“Physical activity was roughly twice as effective in lowering cardiovascular disease risk among those with depression. Effects on the brain’s stress-related activity may explain this novel observation,” says Tawakol, the study’s senior author.
The authors note that prospective interventional studies are needed to confirm causal pathways and identify mediating mechanisms. Meanwhile, clinicians can inform patients that physical activity not only benefits the heart directly but also improves brain systems that regulate stress—potentially delivering even greater cardiovascular gains for people with stress-related syndromes like depression.
Authorship:
Hadil Zureigat MD; Michael T. Osborne, MD; Shady Abohashem, MD; Kenechukwu Mezue, MD; Charbel Gharios, MD; Simran Grewal, DO; Alex Cardeiro; Nicki Naddaf; Giovanni Civieri, MD; Taimur Abbasi, MD; Azar Radfar, MD; Wesam Aldosoky, MD; Antonia V. Seligowski, PhD; Meagan M. Wasfy, MD; James Sawalla Guseh, MD; Timothy W. Churchill, MD; Rachel P. Rosovsky, MD; Zahi Fayad, PhD; Anthony Rosenzweig, MD; Aaron Baggish, MD; Roger K. Pitman, MD; Karmel W. Choi, PhD; Jordan Smoller, MD; and Lisa M. Shin, PhD.
Funding:
This research was supported by the National Institutes of Health.
About this exercise, stress, and cardiovascular disease research news
Author: Brandon Chase
Source: Mass General
Contact: Brandon Chase – Mass General
Image: The image is credited to Neuroscience News
Original Research: Open access. “Effect of Stress-Related Neural Pathways on the Cardiovascular Benefit of Physical Activity” by Ahmed Tawakol et al., Journal of the American College of Cardiology.
Abstract
Effect of Stress-Related Neural Pathways on the Cardiovascular Benefit of Physical Activity
Background
The biological mechanisms that link physical activity with improvements in psychological well-being and reduced cardiovascular disease (CVD) risk are not fully understood.
Objectives
This study evaluated whether physical activity: 1) reduces stress-related neural activity that contributes to CVD and to anxiety or depression; 2) lowers CVD risk in part through its effects on these neural pathways; and 3) provides greater cardiovascular protection for individuals with depression.
Methods
Researchers studied participants from the Mass General Brigham Biobank who completed a physical activity survey. A subgroup underwent 18F-fluorodeoxyglucose positron emission tomography/computed tomography imaging. Stress-related neural activity was quantified as the ratio of resting amygdalar-to-cortical activity (AmygAC). Cardiovascular events were identified through electronic health records.
Results
Fifty thousand three hundred fifty-nine adults were included (median age 60 years; interquartile range 45–70; 40.1% male). Greater physical activity was linked to lower AmygAC (standardized β: −0.245; 95% CI: −0.444 to −0.046; P = 0.016) and to fewer CVD events (HR: 0.802; 95% CI: 0.719–0.896; P < 0.001) after adjusting for multiple variables. Reductions in AmygAC partially mediated the cardiovascular benefit of activity (OR: 0.96; 95% CI: 0.92–0.99; P < 0.05). The protective effect of physical activity on incident CVD was stronger among participants with preexisting depression compared with those without (P interaction = 0.011). Additionally, activity levels above guideline recommendations further decreased CVD events, but this incremental benefit was seen only among those with preexisting depression (P interaction = 0.023).
Conclusions
Physical activity appears to lower cardiovascular risk in part by modulating the brain’s stress-related activity. This neural mechanism may help explain why exercise confers greater cardiovascular protection among individuals with depression.