Blumenthal James A, Smith Patrick J, Jiang Wei, Hinderliter Alan, Watkins Lana L, Hoffman Benson M, Kraus William E, Mabe Stephanie, Liao Lawrence, Davidson Jonathan, Sherwood Andrew
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.
Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27710, USA.
J Cardiovasc Dev Dis. 2022 Sep 22;9(10):320. doi: 10.3390/jcdd9100320.
Anxiety is common among patients with coronary heart disease (CHD) and is associated with a worse prognosis. UNWIND was a 12-week randomized clinical trial comparing exercise and escitalopram to placebo on measures of anxiety, depression, and CHD biomarkers. Primary results of the trial reported that treatment with escitalopram, but not exercise, was associated with significant reductions in anxiety and depression. At 1-year follow-up, participants completed the Hospital Anxiety-Depression Scale-Anxiety (HADS-A) along with the HADS-Depression (HADS-D), the Beck Depression Inventory-II (BDI-II), and the Godin Leisure Time Exercise survey to assess physical activity. Results showed that those patients randomized to escitalopram had lower scores on the HADS-A compared to those randomized to exercise ( = 0.006) and had less depression compared to exercise on the HADS-D ( = 0.004) and BDI-II ( = 0.004). Participants randomized to exercise reported higher levels of physical activity at 1-year compared to those randomized to Placebo ( = 0.039). However, despite reporting being more physically active, those randomized to exercise did not have less anxiety or depression compared to placebo controls. Escitalopram appears to be a safe and effective treatment for anxiety; exercise has many health benefits, but does not appear to be effective in treating anxiety.
焦虑在冠心病（CHD）患者中很常见，且与较差的预后相关。UNWIND是一项为期12周的随机临床试验，比较了运动和艾司西酞普兰与安慰剂在焦虑、抑郁和冠心病生物标志物测量方面的效果。该试验的主要结果报告称，艾司西酞普兰治疗而非运动与焦虑和抑郁的显著降低相关。在1年随访时，参与者完成了医院焦虑抑郁量表-焦虑（HADS-A）以及医院焦虑抑郁量表-抑郁（HADS-D）、贝克抑郁量表第二版（BDI-II）和戈丁休闲时间运动调查，以评估身体活动情况。结果显示，与随机分配到运动组的患者相比，随机分配到艾司西酞普兰组的患者在HADS-A上得分更低（P = 0.006），在HADS-D（P = 0.004）和BDI-II（P = 0.004）上与运动组相比抑郁程度更低。与随机分配到安慰剂组的患者相比，随机分配到运动组的参与者在1年时报告的身体活动水平更高（P = 0.039）。然而，尽管报告身体活动更多，但与安慰剂对照组相比，随机分配到运动组的患者焦虑或抑郁程度并未减轻。艾司西酞普兰似乎是一种安全有效的焦虑治疗方法；运动有许多健康益处，但似乎对治疗焦虑无效。
