Returning to activity within the first 6 months after a heart attack may be positively associated with long-term survival, according to an observational study.
After a heart attack, fears related to a return to routine appear. The greatest concerns are centered on activities that may put a greater strain on the heart, such as bearing weight, playing sports and, something that is less talked about, but which is usually an issue that worries men and women: sexual relations. In that sense, a recent observational study found that resuming sexual activity within the first six months after a heart attack can be positively associated with long-term survival.
Sexuality and sexual activity “they are markers of well-being” and retaking them “soon after a heart attack can be part of the self-perception of a healthy, functional, young and energetic person, which can lead to an overall healthier lifestyle,” said Yariv Gerber of the University of Tel Aviv, author of the work published in European Journal of Preventive Cardiology.
Gerver, however, clarified that it is an observational study, so “causality cannot be assumed”. She also noted as a limitation that the low proportion of women and the relatively young age of the participants may limit the generalizability of the results.
Data were obtained from the Israel Study on First Acute Myocardial Infarction, which included 495 sexually active patients from 65 years or younger, who were hospitalized for a first heart attack between 1992 and 1993. The mean age was 53 years.
Information on the frequency of sexual activity was collected through two interviews, one during the initial hospitalization, when sexual activity was reported in the previous year, and the other from 3 to 6 months later.
Taking these data into account, the participants were classified into two groups: those who abstained from sexual activity or decreased its frequency after the heart attack (47%) versus those who maintained or increased it (53%).
The study made a mean follow-up of 22 years, during which 211 (43%) patients died.
When comparing the risk of death between the two groups, differences in other characteristics that could also predict mortality were taken into account, such as socioeconomic status, depression, physical activity, obesity, self-rated health, and severity of the attack cardiac.
The analysis indicated that maintaining or increasing the frequency of sexual activity within the first six months after a heart attack was associated with a 35% lower risk of death compared to abstention or reduction.
The survival benefit related to maintaining or increasing the frequency of sexual activity was mainly attributed to the reduction in non-cardiovascular mortality, such as cancer.
Gerber said that becoming sexually active again soon after a heart attack can be an indicator of a best clinical rehabilitation and psychosocial, that is, a better recovery.
“The improvement of physical fitness, the strengthening of relationships with the spouse and the mental capacity to ‘recover’ from the initial shock of the event (the heart attack) in a few months are – he considered – some of the possible explanations of the benefit of survival”.
One of the frequent questions that usually appear among those who want to resume their sexual life after a heart attack is related to when to resume it. An article from the Spanish Heart Foundation (FEC) indicates that it is more advisable to do it “after adequate and progressive physical and psychological training.” “Thanks to this planning,” she continues, “one learns to detect the physical responses of the body after an effort. From a psychological point of view, the training will lead the patient to recognize what their harmful emotional relationships are and how to control
Another fear that often appears is whether sexual relations can be risky. From the FEC and the American Heart Association (AHA, for its acronym in English) they take comfort in pointing out that the energy expenditure made during sexual intercourse is similar to that generated by climb two floors by ladder. “The heart rate of intercourse is lower than that produced during other normal activities of daily life, and the physical effort required could be classified as moderate, which in principle would not bring any complications,” they point out from the FEC.
“If your doctor doesn’t offer it, ask him or her to give you a stress testIf you can exercise on a treadmill at a rate of more or less 5 to 6 kilometers per hour, it will be fine, “they point out from the AHA. According to a scientific statement from the entity, it is probably safe to have sex if cardiovascular disease is stabilized.
Regarding the problems for the heart that can appear during sexual intercourse, the FEC affirms that it is most likely that there are none. “There are cases in which angina pectoris may occasionally appear during sexual activity, which could cause a state of significant anxiety. Most likely, this will happen to someone who has the same risk when performing any other moderate physical effort” they point out. Death during sex is very rare.