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November 7, 2012

Physical Activity to Combat Depression in Chronic Heart Failure—Reply

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina (Drs Blumenthal and Babyak) (blume003@mc.duke.edu); and Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania (Dr Whellan).

JAMA. 2012;308(17):1738-1739. doi:10.1001/jama.2012.14098

In Reply: Dr Sossai and Mr Sponga suggest that we consider race and heart failure severity as potential moderators of treatment in the HF-ACTION trial1 and that we examine more thoroughly the relationship between exercise adherence and depressive symptoms measured by the BDI-II.

Because blacks may respond differently to various cardiac medications, Sossai and Sponga suggest that we examine the response of blacks to the exercise intervention. This suggestion is especially relevant because depression may be less likely to be recognized in blacks,2 and is even less likely to be treated.3 However, the absence of a treatment group × race interaction for BDI-II scores in the HF-ACTION trial suggests that blacks responded to exercise in a similar manner compared with their white counterparts. We plan to examine this issue in greater detail in a subsequent report.