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New research from Radboudumc highlights the potential of exercise to improve mental health and quality of life in individuals with coronary artery disease. These patients are at higher risk of cognitive decline, depression, and reduced quality of life, but exercise may offer significant benefits.
Individuals with cardiovascular diseases have a substantially higher incidence of cognitive impairment, a poorer mental health and a reduced quality of life compared with age-matched healthy controls. Mounting evidence supports that exercise training has important systemic and multi-organ health benefits and could potentially improve brain-related health outcomes in individuals with coronary artery disease.
A recent network meta-analysis published in European Heart Journal led by researchers of the Radboudumc and the University of Granada examined whether different types and settings of exercise could improve quality of life, depression and anxiety. The authors meta-analyzed 36 studies involving a total of 3,534 patients with coronary artery disease worldwide. The network meta-analysis, a State-of-the-Art meta-analysis technique, allowed the comparison of multiple types of exercise, such as high-intensity interval training (HIIT), moderate-intensity training (MIT), combination of HIIT or MIT with resistance exercise and stretching-toning-balance training, and settings of exercise, such as in-person versus home-based.
The results highlighted that the setting in which exercise was performed, rather than the type itself, was key to maximize the benefits for quality of life and mental health. More specifically, in-person supervised exercise programs provided the biggest and significant improvements, while home-based programs showed more modest and non-significant results. Furthermore, high intensity exercise training seems to be equally effective as moderate intensity training in improving health-related quality of life, depression and anxiety. Likewise, the intervention duration or volume of exercise did not impact the outcomes.
The research findings highlight that exercise training, especially in-person programs, could improve the health-related quality of life, attenuate depressive symptoms, and reduce anxiety in patients with coronary artery disease. These results are highly relevant since home-based interventions are promising and probably necessary strategies for future healthcare interventions, in which in-hospital care is transferred to home-based care when possible. Therefore, existing home-based exercise programs should be revised and optimized to increase their efficacy on quality of life and mental health in patients with coronary artery disease.
This project was led by Esmée Bakker of the Radboudumc, as part of her Marie Skłodowska-curie Postdoctoral Fellowship, together with her colleagues from the University of Granada; Ángel Toval and Francisco Ortega. Other collaborators were Thijs Eijsvogels (Radboudumc) and other researchers from the University of Granada and University of Castilla-La Mancha (Spain).
About the publication
Angel Toval, Esmée A Bakker, Joao Bruno Granada-Maia, Sergio Núñez de Arenas-Arroyo, Patricio Solis-Urra, Thijs M H Eijsvogels, Irene Esteban-Cornejo, Vicente Martínez-Vizcaíno, Francisco B Ortega,. Exercise type and settings, quality of life, and mental health in coronary artery disease: a network meta-analysis, European Heart Journal, 2025.
