Heart disease health centre

No need to avoid sex after heart attack

By Lilian Anekwe

BMJ Group News

What do we know already?

Many people who have had a heart attack in the past have concerns that having sex could trigger a repeat attack.

It’s true that during sex your blood pressure and heart rate can increase mildly. The greatest increases occur during the 10 to 15 seconds of orgasm, but both blood pressure and heart rate soon return to normal.

Previous studies have shown that sex is comparable to mild to moderate physical activity in the range of three to four metabolic equivalents (METS). This is the equivalent of climbing two flights of stairs or walking briskly for a short time.

But these studies have mainly been done in young and fit men, so there is a need for more research about the impact of sexual activity on older people, women, and those with heart disease. It’s possible that sex might put more strain on the heart for older people.

What does the new study say?

A review of evidence from four studies of 2,960 people found that having sex nearly trebled the risk of a heart attack compared with when people were not engaged in sexual activity.

But the absolute chance of this happening is very low. The researchers estimated that less than one in every 100 heart attacks is brought on by sex, and there would be only two to three extra heart attacks due to sex for every 10,000 people who had one hour of sexual activity each week.

Also, the additional risk of a heart attack from sex wasn’t any greater in people who had previously had a heart attack, compared with people who had not.

Looking at people who had previously had a heart attack, the researchers found that sexual activity increased their risk of a repeat heart attack or death, from 10 chances in 1 million per hour to between 20 and 30 chances in 1 million per hour.

Some drugs to treat heart disease have been linked to problems with erections, but the researchers say this effect has been overstated in the past, and there is little evidence that the drugs actually cause the problem. Instead, they believe, erection problems may be caused by anxiety about the heart condition.

The researchers warn that herbal medicines that are claimed to treat sexual problems may increase the risk of heart problems, or interfere with drugs to treat heart problems.

How reliable is the research?

The review looked at evidence from all of the studies that have been done on sexual activity and heart attacks, and so should be a reliable source of evidence.

What does this mean for me?

Sexual activity is an important part of life. This review shows for most people who have previously had a heart attack that there is a very low risk of a repeat attack caused by sexual activity. People who have had a previous heart attack can lower their risk of a repeat attack if they are fit, and exercise training could also improve your general health and quality of life. It’s important though if you have had a previous heart attack to stop and rest if you start to feel out of breath and tell your doctor if physical activity brings on chest pain or shortness of breath.