Effects of Exercise on Depression and Anxiety in People with Coronary Heart Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

This study aimed to evaluate the effects of exercise on depression and anxiety in patients with coronary heart disease (CHD) and to identify exercise parameters associated with more favorable psychological outcomes. PubMed, Web of Science, Embase, Cochrane Library, and Scopus were systematically searched from database inception through 30 May 2026. Pooled effects were quantified as standardized mean differences (SMDs), accompanied by 95% confidence intervals. Thirteen studies fulfilled the eligibility criteria. Exercise significantly alleviated depression (SMD, −1.84, P = 0.0003) and anxiety (SMD, −1.78, P = 0.0009) in CHD patients. Among exercise modalities, aerobic exercise was associated with significant reductions in depression (SMD, −2.29, P = 0.002) and anxiety (SMD, −2.20, P = 0.006). Subgroup analyses indicated greater benefits with supervised (depression, SMD, −2.88, P = 0.002; anxiety, SMD, −2.72, P = 0.007) and moderate-intensity aerobic exercise (depression, SMD, −0.87, P = 0.006; anxiety, SMD, −1.14, P = 0.007), particularly when performed >3 times per week (depression, SMD, −0.85, P = 0.007; anxiety, SMD, −0.58, P = 0.01) and with session durations of ≤60 min (depression, SMD, −2.60, P = 0.01; anxiety, SMD, −2.32, P = 0.02). Overall, exercise, particularly aerobic exercise, appeared to alleviate depression and anxiety in CHD patients. The available evidence suggests that moderate-intensity aerobic exercise, conducted under supervision, >3 times weekly, with each session lasting ≤60 min, may be particularly beneficial.