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AHA: Sex Safe for Most Heart Patients

Risk to Individual Patient ‘Extraordinarily Low’
By
WebMD Health News
Reviewed by Laura J. Martin, MD

Jan. 19, 2012 -- Most patients can safely resume sexual activities one week after having an uncomplicatedheart attack, according to a new report from the American Heart Association.

The report represents the most comprehensive review of the research on sex in heart patients ever conducted by the group, and it is intended to help patients and their doctors discuss the subject.

Among the main findings:

  • Sexual activity is safe for most heart patients with stable heart disease.
  • Drugs used to treat erectile dysfunction are generally safe for men with stable heart disease unless they are taking nitrates for chest pain. Nitrates should never be used within 24 to 48 hours of using an erectile dysfunction drug.
  • Patients with severe heart disease who experience chest pain (angina) or other symptoms with minimal or no activity should refrain from sex until their symptoms are stabilized with treatment.

“Patients may be nervous about asking their doctor about sex,” says researcher Glenn N. Levine, MD, professor of medicine at Baylor College of Medicine.

“There is a misperception that many patients with heart disease should not have sexual relations,” he says. “This is in part due to the rare, sensationalized cases of politicians and other celebrities dying during sex.”

Heart Attacks, Death During Sex Very Rare

The research review confirmed that these widely publicized cases are very much the exception and not the norm.

Sexual activity was found to be the cause of less than 1% of all heart attacks and less than 1% of all cases of sudden death related to heart ailments or stroke.

Having sex was associated with a two- to threefold increase in heart attack risk among heart patients, but Levine characterizes the risk to the individual patient as “extraordinarily low.”

“It is important to remember that the vast majority of heart attacks occur when people are not having sex,” he says.

In one autopsy study involving 5,559 people who died suddenly from heart arrhythmias (a disruptive heart rhythm), just 34 (0.6%) of the deaths reportedly occurred during sexual activity. Two other studies reported similarly low rates of sudden death associated with sex.

Most of these cases occurred in men, and three out of four of these deaths involved extramarital sex, most often with a younger partner in an unfamiliar setting.

“One could speculate that higher anxiety or higher adrenaline might have been involved in these deaths, but because the numbers were so small I wouldn’t want to read too much into this,” Levine says.

Chest pain associated with sexual activity, known medically as coital angina, was also uncommon, accounting for less than 5% of all angina attacks.

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