What is the clinical evidence from this study?

Study design: RCT. Population: Coronary heart disease with elevated depressive symptoms (n=101). Intervention: Aerobic exercise or sertraline vs. Placebo. Primary outcome: Change in Hamilton Rating Scale for Depression (HAM-D) score (p=0.034).

What question did this study set out to answer?

This research aims to evaluate the effectiveness of exercise versus sertraline in alleviating depressive symptoms and enhancing cardiovascular metrics among coronary heart disease patients.

June 29, 2026Journal of the American College of Cardiology

Exercise and Pharmacological Treatment of Depressive Symptoms in Patients With Coronary Heart Disease

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Key result

Aerobic exercise and sertraline reduce depressive symptoms more than placebo in CHD patients.

P=0.034
n=101

Why the study?

Clinical depression is associated with poor prognosis in patients with CHD, but optimal therapeutic strategies remain not well-defined.

Does aerobic exercise or sertraline reduce depressive symptoms in outpatients with coronary heart disease?

Key Points

This research aims to evaluate the effectiveness of exercise versus sertraline in alleviating depressive symptoms and enhancing cardiovascular metrics among coronary heart disease patients.
101 outpatients with coronary heart disease and depressive symptoms were assessed using psychiatric interviews and the Hamilton Rating Scale for Depression.
Participants were randomized to receive aerobic exercise, sertraline, or placebo for 4 months, focusing on improvements in depressive symptoms and cardiovascular biomarkers.
Assessments included heart rate variability, endothelial function, inflammation, and platelet function.
Both exercise (M= −7.5, 95% CI = −9.8, −5.0) and sertraline (M= −6.1, 95% CI = −8.4, −3.9) showed significant reductions in depressive symptoms compared to placebo (M= −4.5, 95% CI = −7.6, −1.5; p = .034).
The effectiveness of exercise and sertraline in reducing depressive symptoms was not significantly different (p = .607).
Exercise and sertraline showed trends towards greater improvements in heart rate variability compared to placebo (p = .052) and between each other (p = .093).

Study Design

Type

RCT (n=101)

Randomization

randomized

Structured PICO

Does aerobic exercise or sertraline reduce depressive symptoms in outpatients with coronary heart disease?

Population

101 outpatients with coronary heart disease and elevated depressive symptoms, randomized to aerobic exercise, sertraline, or placebo for 16 weeks.

Intervention

Aerobic exercise (3 times/week) or sertraline (50-200 mg/day) for 4 months

Comparator

Placebo

Outcome

Reduction in depressive symptoms measured by the Hamilton Rating Scale for Depression (HAM-D) at 16 weekspatient reported

Main Result

Absolute Event Rate: -7.5% vs -4.5%

p-value: p=0.034

In patients with coronary heart disease and elevated depressive symptoms, both aerobic exercise and sertraline significantly reduced depressive symptoms compared to placebo.

Discussion

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Key expert perspectives

Captured external expert commentary on this paper, strongest first. Original sources are linked where available.

JA James A. BlumenthalProfessor of psychiatry, Duke University Medical Center

“These results are the first from a randomized clinical trial to show that exercise reduces depressive symptoms in stable CHD, which is particularly important in light of the growing evidence that depression is associated with increased risk for fatal and nonfatal events in a wide range of CHD populations.”

Duke UniversityNews Coverage

FDFrank DoyleSenior Lecturer, Population Health Sciences, RCSI

“Our study indicates that exercise is likely to be the best treatment for depression following coronary artery disease. Our findings further highlight the clinical importance of exercise as a treatment as we see that it improves not only depression, but also other important aspects of heart disease, such as lowering blood pressure and cholesterol, in these patients.”

RCSI University of Medicine and Health SciencesNews Coverage

Implication

May support exercise or sertraline for depression in CHD patients; leaves open optimal strategies and cardiovascular outcomes.

Cite This Study

Blumenthal et al. (2012) conducted an RCT in Coronary heart disease with elevated depressive symptoms (n=101). Aerobic exercise or sertraline vs. Placebo was evaluated on Change in Hamilton Rating Scale for Depression (HAM-D) score (p=0.034). Aerobic exercise (mean change -7.5) and sertraline (-6.1) achieved larger reductions in depressive symptoms compared to placebo (-4.5; p=0.034) in patients with coronary heart disease.

synapsesocial.com/papers/6a428cf0abd2828dd15b1ae4 https://doi.org/10.1016/j.jacc.2012.04.040

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Exercise and Pharmacological Treatment of Depressive Symptoms in Patients With Coronary Heart Disease

Key Points

Study Design

Structured PICO

Main Result

Discussion

Key expert perspectives

Implication

Cite This Study

Exercise and Pharmacological Treatment of Depressive Symptoms in Patients With Coronary Heart Disease

Key Points

Study Design

Structured PICO

Main Result

Discussion

Key expert perspectives

Implication

Cite This Study

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