Sexual Activity and Cardiovascular Disease

Levine, Glenn N.; Steinke, Elaine E.; Bakaeen, Faisal G.; Bozkurt, Biykem; Cheitlin, M.D.; Conti, Jamie B.; Foster, Elyse; Jaarsma, Tiny; Kloner, Robert A.; Lange, Richard A.; Lindau, Stacy Tessler; Maron, Barry J.; Moser, Debra K.; Ohman, E. Magnus; Seftel, Allen D.; Stewart, William J.

doi:10.1161/cir.0b013e3182447787

Cited by 291 publications

(217 citation statements)

References 146 publications

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“…Approximately 60% to 87% of patients with HF report sexual problems 8. These problems include a marked decrease in sexual interest and activity, and one quarter of patients with HF report that they have stopped sexual activity altogether 1, 12.…”

Section: Prevalence Of Sexual Problems In Heart Failure Patientsmentioning

confidence: 99%

“…Digoxin and mineralocorticoid receptor antagonist are also described to have an effect on sexual performance or libido 23. Furthermore, the use of beta blockers can reduce sexual function;8, 23 however, data on third generation beta blockers currently used for HF treatment are inconsistent 23. HF patients have even reported an improvement of sexual performance with beta blockers, which is likely to be a result of both a reduction of HF severity and the ancillary properties of some of the third generation beta blockers 17.…”

Section: Medication and Device Therapymentioning

confidence: 99%

“…HF patients have even reported an improvement of sexual performance with beta blockers, which is likely to be a result of both a reduction of HF severity and the ancillary properties of some of the third generation beta blockers 17. In addition, a nocebo effect, in which a patient's knowledge that a drug has been associated with ED, is often at least as important a contributing factor to a patient's ED as any physiological effect, particularly with contemporary blockers 8. In patients who develop sexual problems as a result of medication therapy, it can be helpful to switch to another drug from the same class or find a reasonable alternate strategy 8…”

Section: Medication and Device Therapymentioning

confidence: 99%

“…The energy required for sexual activity depends on its intensity and a person's physical condition. In the AHA statement, the physical effort related to sexual activity in cardiac patients is described to be considered as mild to moderate physical activity and the related energy expenditure in the range of three to five metabolic units (METs) 8. The amount of energy needed for sexual activity is often compared with the energy needed to climb three flights of stairs, general housework, or gardening.…”

Section: Energy Consumption and Risk Related To Sexual Activitymentioning

confidence: 99%

“…They may have questions about when to resume sexual activity, about possible dangers and what to do in case symptoms occur. In the American Heart Association (AHA) scientific statement on sexual Activity and Cardiovascular Disease,8 sexual activity is described to be reasonable for patients with compensated and/or mild [New York Heart Association (NYHA) class I or II] HF (Class IIa; Level of Evidence B). Sexual activity is not advised for patients with decompensated or advanced HF (NYHA class III or IV) until their condition is stabilized and optimally managed (Class III; Level of Evidence C).…”

Section: Introductionmentioning

confidence: 99%

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Sexual function of patients with heart failure: facts and numbers

Jaarsma

2016

ESC Heart Failure

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Approximately 60% to 87% of patients with heart failure (HF) report sexual problems, and numbers as low as 31% of HF patients younger than 70 have normal sexual function. When compared with healthy elders, the amount of perceived sexual dysfunction might be similar (around 56%), but patients with HF are reporting more erectile dysfunction (ED) and also perceive that their HF symptoms (20%) or HF medication (10%) is the cause for their problems. The prevalence of ED is highly prevalent in men with cardiac disease and reported in up to 81% of cardiac patients, compared with 50% in the general older population. In total 25–76% of women with HF report sexual problems or concerns.The physical effort related to sexual activity in cardiac patients can be compared to mild to moderate physical activity. The related energy expenditure of sexual activity falls in the range of three to five metabolic units (METs), which can be compared to the energy needed to climb three flights of stairs, general housework, or gardening.Information about sexual activity is often overlooked by health care professionals treating HF patients. Advice and counselling about this subject are needed to decrease worries of patients and partners, avoid skipping medication because of fear for side effects, or prevent inappropriate use of potency enhancing drugs or herbs.

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Section: Prevalence Of Sexual Problems In Heart Failure Patientsmentioning

confidence: 99%

Section: Medication and Device Therapymentioning

confidence: 99%

Section: Medication and Device Therapymentioning

confidence: 99%

Section: Energy Consumption and Risk Related To Sexual Activitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sexual function of patients with heart failure: facts and numbers

Jaarsma

2016

ESC Heart Failure

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Sexual Activity and Function in the Year After an Acute Myocardial Infarction Among Younger Women and Men in the United States and Spain

et al. 2016

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Importance The majority of young adults who have an AMI are sexually active before AMI, but little is known about sexual activity or sexual function afterwards. Objective Describe patterns of sexual activity and function and identify predictors of loss of sexual activity in the year after AMI. Design, Setting, and Participants Data from the prospective, longitudinal Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) study (2008–12) were assessed at baseline, one month, and one year. Participants (women = 1,889; men = 913) were ages 18–55 at enrollment from United States (n=103) and Spanish (n= 24) hospitals who completed baseline and all follow-up interviews. Characteristics associated with loss of sexual activity were assessed using multinomial logistic regression analyses. Main Outcome Measure Loss of sexual activity after AMI. Results At all time points, 40% of women and 55% of men were sexually active. Among people who were sexually active at baseline, men were more likely than women to have resumed sexual activity by one month (64% versus 55%, p<0.001) and by one year (94% versus 91%, p=0.01) after AMI. Among people who were sexually active before and after AMI, women were less likely than men to report no sexual function problems in the year after (40% vs. 55%, p<0.01). Additionally, more women than men (42% vs. 30%, p<0.01) with no baseline sexual problems developed one or more incident problems in the year after AMI. At one year, the most prevalent sexual problems were lack of interest (40%) and trouble lubricating (22%) among women; and erectile difficulties (22%) and lack of interest (19%) among men. Those who had not communicated with a physician about sex in the first month after AMI were more likely to delay resuming sex (adjusted odds ratio (AOR) 1.51, 95% CI 1.11–2.05; p=0.008). Higher stress levels (AOR 1.36, 95% CI 1.01–1.83) and having diabetes (AOR 1.90, 95% CI 1.15–3.13) were significant predictors of loss of sexual activity in the year after AMI. Conclusions and Relevance Impaired sexual activity and incident sexual function problems were prevalent and more common among young women than men in the year after AMI. Attention to modifiable risk factors and physician counseling may improve outcomes. Trial registration NCT00597922

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