Heart Attack

Growing old doesn’t mean you have to give up on your sex life. Even after you’ve had a heart attack.

In a new study, researchers from Germany say that the benefits of regular sexual activity outweigh the small risk faced by people with heart disease.

"Based on our data, it seems very unlikely that sexual activity is a relevant trigger of heart attack," study author Dr. Dietrich Rothenbacher, MPH, professor and chair of the Institute of Epidemiology and Medical Biometry at Ulm University, said in a press release.

After a heart attack, patients may be concerned about returning to their usual sexual activities. They may even worry that the physical exertion of sex will trigger another heart attack.

In spite of what sometimes appears in R-rated movies, sex is actually not that strenuous. The authors note that other research has found that sex is only moderately intense, on par with heavy cleaning or brisk walking.

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Heart Patients Studied Over a Decade

In the new study, researchers asked 536 heart disease patients between 30 and 70 years old how often they had sex during the 12 months before they had a heart attack.

More than half of the patients reported some sort of sexual activity at least once per week. Around 15 percent of the patients said that they had no sexual activity during those 12 months.

Patients were asked to recall this from memory, which could alter the results.

Researchers followed the patients for 10 years after the heart attack. During that time, there were 100 cardiovascular events, such as heart attack, stroke, or death from heart disease.

The researchers also looked at the timing of the sexual activity. Less than 1 percent of the patients reported having sexual activity within an hour before their heart attack. The majority of people had sex at least 24 hours before their heart attack.

After taking into account various risk factors for heart disease and the physical activity level of patients, the authors concluded that patients should not be concerned about resuming their sexual activities.

“The results of the study … provide additional evidence that the risk of a myocardial infarction with sexual activity is low. This is consistent with prior studies,” Elaine Steinke, PhD, a professor in the school of nursing at Wichita State University, told Healthline.

The study was published online today in the Journal of the American College of Cardiology.

Other studies have found that sexual activity may increase the risk of a heart attack or other cardiac events. This risk was lower in people who exercised regularly.

A 2012 statement by the American Heart Association, though, supports the current study. These guidelines indicate that sexual activity is “reasonable” at least one week after an “uncomplicated” heart attack, provided patients don’t have any heart symptoms during mild to moderate physical activity.

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Encouraging an Active Sex Life

Sex is often intimately tied to a person’s quality of life, even for those who have had a heart attack.

Concerns about the heart or fears about health may derail a patient’s return to a full sex life.

“Many cardiac patients want to remain sexually active after a myocardial infarction,” said Steinke, “but fears about the risks of sex may stop them from engaging in sex.”

The authors of the new study write that it is important for healthcare providers to reassure patients about their sexual activities. This type of counseling — which also addresses anxiety and fears — may not be a routine part of a patient’s care.

A 2012 study found that only one-third of women and less than half of men who had suffered a heart attack received information about resuming sexual activity.

Partners often have similar or greater concerns as patients, so addressing partner concerns is important as well.
Elaine Steinke, Wichita State University

To address this, the AHA created guidelines in 2013 that highlight the importance of sexual counseling for patients with heart disease — and their partners.

 “Partners often have similar or greater concerns as patients, so addressing partner concerns is important as well,” said Steinke. “This is important in supporting sexual quality of life.”

At the same time, healthcare providers should be discussing the potential side effects of medications with patients. Certain drugs can cause erectile dysfunction. And some heart medications, when combined with drugs to treat erectile dysfunction, may lead to a sudden drop in blood pressure.

In addition, patients may want more detailed information such as the warning signs of heart problems they should keep an eye out for, and even the best positions for sex after a heart attack.

“Patients want to know not only when to resume sex,” said Steinke, “but how to go about doing so.”

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