Association Between Hospital Anxiety Depression Scale and Autonomic Recovery Following Exercise

  • Milana D. R. Santana
  • David M. Garner
  • Yasmim M. de Moraes
  • Luana B. Mangueira
  • Guilherme C. Alcantara
  • José R. A. da Silva
  • Rodrigo D. RaimundoEmail author
  • Fernando R. Oliveira
  • Vitor E. Valenti


The hospital anxiety depression scale (HADS) is a benchmark used to investigate possible and probable cases of psychosomatic illness. Its affiliation with autonomic recovery after exercise is unclear and, as a technique applied to evaluate cardiovascular risk. We assessed a possible link between HADS and autonomic recovery after exercise. We studied healthy subjects split into two groups: Low HADS (n = 20) and High HADS (n = 21). Subjects consented to moderate aerobic exercise on a treadmill at 60% to 65% of the maximum heart rate (HR) for 30 min. We studied HR variability (HRV) before and during 30 min after exercise. Subjects with higher HADS values presented delayed recovery of HR and root-mean square of differences between adjacent normal RR intervals (RMSSD) after submaximal exercise. RMSSD during recovery from exercise had a significant association with HADS. In summary, subjects with higher HADS presented slower vagal recovery following exercise.


Anxiety Autonomic nervous system Depression Cardiovascular system Exercise 



This study received financial support from Foundation of Support to Research from Sao Paulo State (Process 2016/02994-1) and the National Council for Scientific and Technological Development (CNPq), which is linked to the Ministry of Science, Technology, Innovations and Communications.


This study was funded by CNPq (Conselho Nacional de Pesquisas - Grant Number 301784/2014-0) and Foundation of Support to Research from Sao Paulo State (Grant Number 2016/02994-1).

Compliance with Ethical Standards

Conflict of interest

Authors Milana D. R. Santana, David M. Garner, Yasmim M. de Moraes, Luana B. Mangueira, Guilherme C. Alcantara, José R. A. da Silva, Rodrigo D. Raimundo, Fernando R. Oliveira and Vitor E. Valenti declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All methods were approved by the Research Ethics Committee in Research from Faculdade de Juazeiro do Norte (Number 2.244.700). The experimental protocols were performed in accordance with the 466/2012 resolution of the National Health Council of 12/12/2012. Informed consent was obtained from all participants and they signed a confidential consent letter.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Milana D. R. Santana
    • 1
  • David M. Garner
    • 2
  • Yasmim M. de Moraes
    • 1
  • Luana B. Mangueira
    • 1
  • Guilherme C. Alcantara
    • 1
  • José R. A. da Silva
    • 1
  • Rodrigo D. Raimundo
    • 3
    Email author
  • Fernando R. Oliveira
    • 4
  • Vitor E. Valenti
    • 5
  1. 1.Physiological and Pharmaceutical Sciences NucleusSchool of Juazeiro do NorteJuazeiro Do NorteBrazil
  2. 2.Cardiorespiratory Research Group, Department of Biological and Medical Sciences, Faculty of Health and Life SciencesOxford Brookes UniversityOxfordUK
  3. 3.Design of Studies and Scientific Writing LaboratoryABC School of MedicineSanto AndréBrazil
  4. 4.Department of Epidemiology, School of Public HealthUniversity of São Paulo, USPSao PauloBrazil
  5. 5.Autonomic Nervous System CenterUNESPMaríliaBrazil

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