Sex Safe for Heart Patients Not Having an Extramarital Affair

By Nicole Ostrow -
Jan 19, 2012

Most people being treated for heart
disease can safely have sex, according to research that also
suggests the risk of sudden cardiac death may rise for men when
the amorous activity occurs in an extramarital affair.

The act of intercourse is generally comparable to climbing
two flights of stairs, said Glenn Levine, a professor of
medicine at Baylor College of Medicine in Houston and the
paper’s lead author. The scientific statement, published in the
Dallas-based heart group’s journal, Circulation, may provide a
road map for doctors to counsel patients, he said.

“It is only a modest number of patients with more severe
or unstable symptoms who should defer sexual activity until
evaluated and treated,” Levine said in a telephone interview.
“Our recommendations apply to anyone of any age with heart
disease, including younger persons with congenital heart disease
and other patients including patients in their 70s and 80s.”

Levine’s research group reviewed more than 100 studies to
determine the risks. In autopsy reports of 5,559 cases of sudden
death, 0.6 percent occurred during sexual intercourse, they
found. Of those who died, 82 percent to 93 percent were men and
75 percent were having extramarital sex, in most cases with a
younger partner and after excessive food and alcohol
consumption, the report said.

Risk of Affairs

The study on the autopsy reports involved “only a very
modest number of patients,” and thus “there is no way to know
how much, if any, an extramarital affair relationship truly
increases risk or the mechanism,” said Levine, who directs the
Cardiac Care Unit at the Michael E. DeBakey VA Medical Center.

“I would not blow this too out of context,” he said.
“Without being sarcastic, I really can state that I have not
ever had a patient who asked me about the cardiac risks of an
extramarital affair.”

While the risk of heart attack during sexual activity is
about 2-3 times higher than during periods when one isn’t
engaging in sexual activity, the actual absolute risk of heart
attack during sexual activity is minuscule, according to Levine.

‘Good Emotionally’

Patients should know that sexual relations are an important
part of getting their lives back to normal after heart disease
and should feel comfortable talking about their sexual activity
with their doctors, said cardiologist Peter Alagona, co-director
of the Penn State Hershey Heart and Vascular Institute’s Cardiac
Rehabilitation Program in Pennsylvania.

“A healthy sex life, a healthy intimate life, is an
important aspect of a normal, healthy existence,” said Alagona,
who wasn’t an author of today’s paper, by telephone. “It’s good
physically, it’s good emotionally. What we need to encourage
people to use is common sense.”

How quickly someone with heart disease can resume having
sex after an event like a heart attack or surgery depends on the
severity of their condition, Levine said. A person who had a
small heart attack or one episode of chest pain may be able to
resume sexual activities within a week, while someone who had a
heart attack that required surgery will have to wait longer, he
said.

Current treatments for heart disease very rarely cause
sexual dysfunction, Levine said. He urges patients to take their
medicines as prescribed.

Erection Drugs

Men who have stable heart disease can take medicines to
treat erectile dysfunction, which include New York-based Pfizer
Inc. (PFE)’s Viagra and Indianapolis-based Eli Lilly & Co.’s Cialis.
The erectile treatments shouldn’t be given to patients who are
taking nitrates for chest pains from coronary artery disease,
according to the statement.

The report also found that women who have heart disease
should talk to their doctors about pregnancy and birth control.
Pregnancy can cause changes in a woman’s body that could affect
her heart disease and certain treatments may harm the fetus, the
report said.

The scientific statement provides needed guidelines to help
doctors advise patients with heart disease, said Marian Calfa, a
cardiologist at Jackson Memorial Hospital in Miami.

“We have guidelines and scientific statements in most of
the areas of cardiovascular disease,” said Calfa, who wasn’t an
author on today’s paper, in a Jan. 13 telephone interview.
“This was a missing piece in our portfolio.”