Sex After Heart Attack Called Safe

By William J. Cromie

Gazette Staff

There is little danger in having sex after a heart attack, according to Medical School researchers.

Whether or not a man or woman has heart disease, the biggest risk of an attack occurs in the two hours following sex. For healthy people, that risk is a scant two in a million. If a person has coronary disease, the odds rise to only 20 in a million, or 1 in 50,000.

"I would call that a negligible risk, said James Muller, associate professor of medicine at Deaconess Hospital and lead author of a new study on the subject.

"Our study is the first that provides actual numbers on the risk of sexual activity for heart patients. Before these data became available, doctors had no way to counsel the more than 500,000 people in the United States who survive a heart attack each year and the 11 million people with heart disease. Many of them, and particularly their spouses, were afraid to have sex because they thought it might be very dangerous. It turns out that it's not."

Muller and his colleagues also found that exercise can reduce, if not eliminate, the sexual risk of heart attack. "The study included people who exercised regularly and those who did almost no exercise," he explained. "We found a continuous benefit; that is, the more a person exercised, the less the risk."

A previous study established a risk of one in a million for a heart attack to occur in any given hour for a healthy 50-year-old man. If that fellow has sex, the odds double to two in a million.

To determine that a heart attack or heart disease changes those odds to ten in a million without sex and 20 in a million with sex, Muller's group did bedside interviews of 1,663 male and female heart-attack victims, 858 of whom were still sexually active. The statistical technique they used to obtain those numbers are described in yesterday's Journal of the American Medical Association.

The researchers did not ask interviewees questions about what kind of sex they had, the intensity, or whether or not it was extramarital.

In an editorial titled "One Less Thing to Worry About," Robert Debusk of Stanford University Medical School expressed hope that "the valuable study by Muller (and his colleagues) will embolden physicians to overcome their reticence to discuss this vital aspect of human functioning with their patients. After all, patients are interested not only in the years in their lives, but also in the liveliness of their years."

In a telephone interview, Muller noted that "work on triggers of heart attacks and strokes has been going on at the Harvard Medical School for the past 10 years. In addition to sex, they include anger, heavy exertion, and getting out of bed in the morning. Added up, these triggers account for 17 percent of the 1.5 million heart attacks in the U.S. every year. We continue to look at other possible factors, such as anxiety and stress. I think that we'll find that more than 30 percent of heart attacks will have such triggers Understanding how they work should give us new ways to prevent heart attacks."

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