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Sexual activity safe for patients with CVD
Levine GN. Circulation. 2012;doi:10.1161/CIR.0b013e3182447787.
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A scientific statement released by the American Heart Association reported that patients with stable CVD can safely engage in sexual activity.
“[This scientific statement] is a summary of the present knowledge of the interaction between sexual activity and patients with heart disease,” writing group member Melvin D. Cheitlin, MD, of the University of California, San Francisco, told Cardiology Today. “It gives physicians a brief summary of the physiology of sex and also a good idea of how much increased cardiac demand there is with intercourse.”
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Researchers found that sexual activity is reasonable for patients who can exercise 3 to 5 metabolic equivalents (METs; 1 MET is equal to 3.5 cc O2/kg/min consumed by the body at rest) without experiencing angina, excessive dyspnea, ischemic ST segment changes, cyanosis, hypotension or arrhythmia.
“There are people who have heart disease who simply don’t do anything. In fact, you don’t even know if they can do 3 to 5 METs of activity, even for a short time,” Cheitlin said. “[In that case], an exercise stress test is reasonable.”
Another recommendation is that physicians talk to patients with heart disease about whether it is safe for them to perform sexual activity. Cheitlin, who is also a Cardiology Today Editorial Board member, said that doctors rarely ask patients about their sexual activity and “patients are too fearful or too ashamed to talk about it.”
“Consequently, it never comes up,” he said. “Yet, it’s an important issue because, in many people’s lives, this is an important quality-of-life problem.”
Through randomized trials, the researchers found that patients who go through sexual counseling with their partners have increased knowledge about sexual activity and CVD; a higher likelihood of returning to sexual activity; improved sexual desire and satisfaction; and increased confidence and reduced fear in resuming sexual activity.
Overall, after diagnosis of an acute cardiac event, patients should be evaluated by a physician or health care provider before resuming sexual activity. Undergoing a comprehensive history and physical examination is recommended. The researchers also recommend exercise testing for additional information on safety of sexual activity in patients with indeterminate or unclear risk.
“Patients who are stable with heart disease, HF or coronary disease who still have fairly good physical activity and are not changing can probably have sexual intercourse with extremely low risk,” Cheitlin said.
Disclosure: Dr. Cheitlin reports no relevant financial disclosures.
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