A US randomized clinical trial showed that for patients with coronary heart disease (CHD) and high anxiety, escitalopram was safe and effective for reducing anxiety. The trial included 128 outpatients (mean age 64.6 years, 29% women) with stable CHD and a diagnosed anxiety disorder between January 2016 and May 2020. Patients were randomized to 12 weeks of aerobic exercise 3 times per week at an intensity of 70% to 85% heart rate reserve, escitalopram (up to 20 mg per day), or placebo. Patients of the exercise, and escitalopram groups reported greater reductions in HADS-A score (exercise, −4.0; escitalopram, −5.7) compared with those of the placebo group (−3.5); patients of the escitalopram group reported less anxiety compared with those of the exercise group (−1.67). There was significant postintervention group differences in 24-hour urinary catecholamines, with greater reductions in the exercise, and escitalopram groups compared with the placebo group, and greater reductions in the escitalopram group compared with the exercise group. All groups achieved comparable but small changes in CHD biomarkers, with no differences between groups. Anxiety is common among CHD patients and is associated with worse health outcomes. Source: https://jamanetwork.com/
