While coronary heart disease (CHD) does appear to impact sexual activity, researchers from University College London called this impact “limited,” adding that “more effective” advice could benefit patients, according to a new study in the journal Heart.
CHD occurs when areas of plaque form along the coronary arteries. The blood that flows through these arteries supply the heart with oxygen to keep it healthy. But if blood flow is obstructed by plaque, less oxygen can reach the heart, leaving a person at higher risk for chest pain (angina), heart attack, and heart failure.
Past studies have described a number of sexual issues facing patients with CHD, including erectile dysfunction, orgasm difficulties, and lower sexual satisfaction. However, data in this area are very limited, with minimal research available comparing older patients with and without CHD.
To improve upon this limitation, the researchers collected data from the 2012/2013 wave of the English Longitudinal Study of Ageing (ELSA). Beginning in 2002 and every two years following, ELSA participants completed health-related questionnaires. The participants were men and women age 50 and older living in England.
The researchers also used the Sexual Relationships and Activities Questionnaire (SRA-Q) to assess sexual attitudes, activities, problems, concerns, and satisfaction.
The entire sample consisted of 6690 people – 2,979 men and 3,711 women. Of these, 376 men (12.6%) and 279 women (7.5%) had CHD. Those with CHD tended to be older than those without. The mean age for men with CHD was 71.7 years compared to 65.6 for men without CHD. The women’s ages were 73.8 years and 65.1 years, respectively.
Just over three-quarters of the participants had been diagnosed with CHD four or more years before the study.
The researchers found that men with CHD were less likely to be sexually active compared to men without CHD. For example, only 68.7% of the men with CHD had engaged in sexual activity during the previous year, compared to 80% of men without CHD. For women, the difference between groups was not significant.
Men with CHD were also less likely to think about sex and more likely to have erectile difficulties. These results were also more common in men who had been diagnosed with CHD within the previous four years.
Women diagnosed with CHD within the past four years were less likely to be sexually active than those who had had the illness for four years or longer.
However, participants with and without CHD seemed to have sex with similar frequency. Between 44% and 50% of respondents had had intercourse at least two to three times over the previous month. In addition, men and women with and without CHD had similar rates of sexual concerns, such as concerns about desire, frequency, and orgasm.
The authors emphasized the role of clinicians in counseling heart patients on sexual activity.
“There is a significant but very small risk that sexual activity can trigger acute cardiac events, and beliefs about such effects may be magnified in patients and their families unless healthcare staff provide appropriate advice,” they wrote.
This advice could “[lead] to more satisfying personal lives,” they explained.
Resources
Heart
Steptoe, Andrew, et al.
“Sexual activity and concerns in people with coronary heart disease from a population-based study”
(Full-text. First published online: June 10, 2016)
http://heart.bmj.com/content/early/2016/06/10/heartjnl-2015-308993.full#T3
National Heart, Blood, and Lung Institute
“What Is Coronary Heart Disease?”
(Updated: June 22, 2016)
http://www.nhlbi.nih.gov/health/health-topics/topics/cad