Physical activity and cardiovascular health in depression: Links between changes in physical activity and cardiovascular risk

To examine the association between changes in physical activity before and after a diagnosis of depression and risks of cardiovascular diseases (CVDs) and all-cause mortality. A total of 1,282,160 patients with depression were included in the analyses. Subjects were divided into four groups (never, beginning, maintenance, and discontinuation) according to changes in physical activity before and after the diagnosis of depression. The occurrence of CVD including myocardial infarction (MI) and ischemic stroke and all-cause mortality were determined. The beginning group showed decreased risks of MI (adjusted hazard ratio [aHR]: 0.85; 95% confidence interval [CI]: 0.81–0.89), ischemic stroke (aHR: 0.89; 95% CI: 0.85–0.93), and all-cause mortality (aHR: 0.80; 95% CI: 0.77–0.82) than the never group. Compared to the maintenance group, the discontinuation group showed increased risks of MI (aHR: 1.15; 95% CI: 1.08–1.23), ischemic stroke (aHR: 1.13; 95% CI: 1.06–1.21), and all-cause mortality (aHR: 1.29; 95% CI: 1.23–1.35). Beginning regular physical activity after a diagnosis of depression was associated with a decreased cardiovascular risk. Discontinuing regular physical activity after a diagnosis of depression was associated with an increased cardiovascular risk. •Depression and physical inactivity are risk factors for cardiovascular diseases.•Engaging in physical activity after depression decreases cardiovascular risk.•Stopping physical activity after depression increases cardiovascular risk.•The risk changes are more prominent in middle-aged and elderly than in young adults.