Advances in Understanding Therapeutic Mechanisms of Exercise Interventions for Individuals with Comorbid Depression and Cardiovascular Diseases: A Narrative Review

Abstract

The aims of this narrative review were to summarize the current literature on the beneficial effects of exercise interventions on individuals with comorbid depression and cardiovascular disease, and to review the current evidence that advances our understanding of the pathophysiological mechanisms underlying these effects. Ninety relevant articles were included and analyzed through a systematic search of PubMed and Web of Science. The analyses indicated that exercise interventions could modulate regulatory pathways to prevent depressive symptoms and reduce adverse cardiovascular events through five mechanisms: promoting immunosuppression, improving mitochondrial function, balancing the autonomic nervous system, up-regulating serum brain-derived neurotrophic factor, and improving vascular endothelial function; and the critical role of integrating the key principles of exercise prescription (frequency, intensity, type, time, volume, and progression) to identify novel therapeutic targets and optimize interventions. In conclusion, this study emphasizes not only the significance of exercise interventions but also the critical role of optimizing exercise prescriptions in managing comorbid depression and cardiovascular disorders. The approach holds important theoretical and clinical practice implications for enhancing both mental and cardiovascular health.