Cardiovascular disease and excess mortality in depression: physical activity as a game changer

Problem: Depression is a widespread disorder and among the leading causes of disability worldwide. In this article, we perform an umbrella review on the association between depression and excess mortality, cardiovascular disease (CVD), and cardiovascular risk factors. We also provide an overview of mechanisms that explain these associations. Finally, we discuss clinical implications from a general perspective and discuss the potential of physical activity to favorably influence the relationship between depression and premature mortality. Methods: Meta-analyses were identified via PubMed. Only works on unipolar depression were included. Results: The association between depression and excess mortality is a robust epidemiological finding. This association can be attributed to the fact that people with depression are at increased risk for CVD and accumulate more cardiovascular risk factors. However, the causal associations are complex. While depression is associated with incident CVD, depression can also be a consequence of cardiac events. Regular physical activity and higher cardiorespiratory fitness levels mitigate the risk of premature mortality associated with depression. Discussion: More attention should be paid to the physical health of psychiatric patients. High priority should be given to the promotion of physical activity and fitness, as they are beneficial for both physical and mental health. Key Words: Fitness, Cardiovascular Disease, Physical Activity, Mortality