Sexual activity and heart attack

Dr Derrick Aarons

Sunday, November 26, 2017

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SEX is considered by many individuals to be an important part of their lives and a major contributor to their quality of life.

Performance of the sex act itself brings good health as well as life-prolonging benefits, and human sexuality has been associated with biological, erotic, physical, emotional, social, and spiritual feelings and behaviours.

Our sexuality also affects and is reciprocally affected by our culture, our political norms, and the legal, philosophical, moral, ethical, and religious aspects of our lives.

Sex and regular sexual activity is therefore of great benefit to us, and is of further benefit when we wish to have children to commence or expand our families. However, as we age, does sexual activity predispose us in later life to sudden cardiac arrest (heart attack)?

What the data shows

Recent research published in the Journal of the American College of Cardiology suggests that the answer to that question is “no”. Sexual activity is rarely the cause of a sudden heart attack, even among patients who have heart disease.

A study funded by the National Heart, Lung, and Blood Institute in the USA and conducted by researchers from the Cedars-Sinai Heart Institute in Los Angeles, California, examined the findings of the Oregon Sudden Unexpected Death Study and analysed data from individuals living in the capital city of Portland, who had experienced a sudden cardiac arrest during the period 2002–2012.

The researchers gathered information about the circumstances surrounding the cardiac arrest, the patient's medical records over their lifetime, and the data arising from the autopsy.

In more than 4,500 cases of sudden cardiac arrest in adults living in Portland, only 34 cases were related to any sexual activity within the preceding hour. The heart attack related to sexual activity occurred in only 32 men and two women.

Statistically, that was one in 100 cardiac arrests in men and one in 1,000 cardiac arrests in women that were related to any sexual activity.

What the doctor should explain

The findings were considered reassuring for doctors and provided data that could help to inform their discussions with patients.

Increasingly, doctors are basing their advice to patients on what is called evidence-based medicine, and so as new research discoveries arise, the resulting information helps to provide the evidence they need to guide their decisions as well as their actions.

Thus, with these research findings, the researchers advised that doctors can now provide reassurance to heart disease patients who exist across the spectrum, based on actual data.

Interestingly, in the few cases of sudden heart attack that occurred during sex and were witnessed by the sexual partners, only one-third of the individuals suffering a heart attack received any cardiopulmonary resuscitation (CPR) from their partners.

Consequently, only one in five such individuals actually survived in hospital until their discharge, since CPR helps to minimise the heart muscle damage that can occur because of a lack of oxygen.

This revelation reinforces the need for the public to be educated, not only on the importance of CPR, but also in how to assist with cardiopulmonary resuscitation.

CPR is important!

Cardiopulmonary resuscitation is the most basic of all medical procedures, yet is the most important.

You should first shake the patient briskly, and if he or she doesn't wake up, you immediately place a call for help to get an ambulance on its way. Next, you imagine a line between the nipples on the person's chest, and place your hands (one hand on top of the other) just below the centre of that imaginary line.

You then push down on the chest hard and fast, about two pushes every second. You keep pushing on the chest until help arrives or the person wakes up and tells you to stop.

What your action is doing is compressing the heart so it can push blood to the brain, thus keeping it alive until medical help arrives.

Low risk

Many doctors have known for some time that the risk of a heart attack is low during sexual activity, but are also aware that many heart patients remain concerned and may not bring up the subject during their visit to the doctor.

The reality is that sexual activity is the equivalent of climbing two flights of stairs, and so persons should be guided by that comparison. Hence, patients who have had a heart attack or have undergone heart surgery may resume sexual activity once they are able to comfortably climb two flights of stairs.

Heart patients in hospital should receive full guidance from their doctors about when they may resume sexual activity, and this should form a part of their pre-discharge education package.

There should be similar discussions at the first follow-up visit by the patient.

Derrick Aarons MD, PhD is a consultant bioethicist/family physician, a specialist in ethical issues in medicine, the life sciences and research, and is the ethicist at the Caribbean Public Health Agency – CARPHA. (The views expressed here are not written on behalf of CARPHA)




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