SEX AND THE HEART

Is there sex after a heart attack? That’s not an uncommon question. And even if a heart patient is too embarrassed to ask, chances are it's on his mind. Researchers from around the world agree: Sexual activity is highly unlikely to trigger a heart attack in a person with or without known heart disease. They also found that a person who exercises regularly after a heart attack is even less likely to suffer a second one as a result of sexual activity.

Those findings were among the many discussed this summer at a groundbreaking conference titled Sexual Activity and Cardiac Risk. Sponsored by UMDNJ- Robert Wood Johnson Medical School, the conference was the first to bring clinicians and human sexuality researchers together. With Viagra on the market for just over a year and a half, the topic has spawned a great deal of interest among patients, physicians and researchers.

Investigators from Harvard Medical School reported that sexual activity does increase the risk of having a heart attack about two-fold in the subsequent two hours. However, because of other factors that can cause myocardial infarction, or MI, the actual risk is very low. And medications, such as aspirin and beta blockers, they said, may alter that risk.

A researcher from St. Thomas Hospital in London looked at individuals with angina, a condition that produces pain upon exertion because of an inadequate blood supply to the heart. He found that in stable angina patients, sex between couples in longstanding relationships did not cause significant increases in blood pressure or heart rate. In fact, the rates were similar to readings taken during normal daily activities. Anti-angina medications were credited. The researcher also reported that the incidence of death resulting from sexual activity is very low, with about 80 percent of those deaths occurring during extramarital sex. He also referred to a previous study that suggested regular activity between long-standing partners possibly even provides protection against MI for middle-aged men.

Adjusting socially and returning to normal activity levels after a heart attack was the focus of research done at SUNY Health Science Center in Brooklyn. Psychological distress following MI was found to sometimes be responsible for erectile dysfunction, and that can in turn lead to depression. The findings suggested, however, that the relationship is a very complex one that needs further study.

“What we've learned here today will be very valuable to physicians and their patients,” said Raymond Rosen, PhD, professor of psychiatry and medicine at RWJMS. “More work needs to be done in this field, especially on the problems of female patients. But we are well on the way to helping victims of heart disease live healthy, fulfilling lives.”

Rosen and John B. Kostis, MD, professor of medicine and pharmacology, co-chaired the conference.