Resuming Sexual Activity Post-Heart Attack Could Increase Survival

Yariv Gerber, PhD

An unspoken concern for many following a heart attack, new research suggests resumption of sexual activity following a heart attack was associated with increased chances for long-term survival.

An analysis of nearly 500 patients aged 65 or younger, results suggest those who maintained or increased their frequency of sexual activity following a heart attack reduced their risk of death by 35% compared to those who decreased or abstained from sexual activity following their heart attack.

“Sexuality and sexual activity are markers of wellbeing,” said lead investigator Yariv Gerber, PhD, professor of epidemiology at Tel Aviv University , in a statement. “Resumption of sexual activity soon after a heart attack may be a part of one’s self-perception as a healthy, functioning, young and energetic person. This may lead to a healthier lifestyle generally.”

For many the idea of returning to vigorous physical activity after myocardial infarction can be intimidating. While previous studies have examined a link between resuming sexual activity and improvements in survival following myocardial infarction, investigators pointed out they failed to assess the impact of resuming sexual activity in the period immediately after the event.

With this in mind, Gerber and a team of colleagues designed the current study with the goal of assessing the impact of resuming or abstaining sexual activity within the first 6 months following acute myocardial infarction. Pulling data from the Israel Study of First Acute Myocardial Infarction, investigators identified 495 patients who met their inclusion criteria for the study.

The Israel Study of First Acute Myocardial Infarction enrolled more than 1600 patients from 1992-1993, however for inclusion in the analysis, patients needed to provide information related to sexual activity before hospitalization and during a second interview 3-6 months detailing sexual activity after hospitalization. In total, 560 patients met these criteria but 65 were eliminated as they reported no sexual activity at baseline.

Of the 495 patients included, 90% were men and the mean age was 53±8 years. From the interviews, investigators determined 73% of patients were sexually active at least once a week prior to the index event. Additionally, 88% of patients resumed sexual activity after the event but only 60% of the total cohort reported similar frequency of sexual activity before and after the event. Based on these results, investigators categorized 263 patients into a group defined by maintained or increased frequency of sexual activity 3-6 months following myocardial infarction and 232 into a group defined by a decrease or entirely abstaining from sexual activity following myocardial infarction.

During the follow-up period, which had a median length of 22 years, 43% of patients included in the current study died. Upon analysis, investigators found maintaining or increasing sexual activity frequency was inversely associated with all-cause mortality (HR, 0.65; 95% CI, 0.48-0.88) when compared against abstaining or reducing frequency. Furthermore, results revealed the inverse association was more robust for non-cardiovascular mortality (HR, 0.56; 95% CI, 0.36-0.85) than cardiovascular mortality (HR, 0.90; 95% CI, 0.53-1.51).

In the aforementioned statement, Gerber noted the observational nature of the study prevents investigators from drawing direct conclusions on the link between sexual activity and increased survival and, because of this, cautions against overinterpretation of results.

“Numerous physical and psychosocial health parameters are required for maintaining regular sexual activity,” Gerber added. “In light of this, the net benefit of sexual activity itself is still a matter of debate.”

This study, “Resumption of sexual activity after acute myocardial infarction and long-term survival,” was published in the European Journal of Preventive Cardiology.