Sexual activity declines for heart attack patients not getting doctors' advice

Sexual activity declines in the year after heart attack for patients who don't get instructions from their doctors about when it's safe to resume sex, researchers reported at the American Heart Association's 11th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke.

In a study of 1,184 male and 576 female acute heart attack patients, nearly half the men and about a third of women reported receiving discharge instructions on resuming sexual activity. Even fewer — less than 40 percent of men and less than 20 percent of women — talked about sex with their physicians in the year following their heart attack.

One year after heart attack, more than two thirds of the men reported some sexual activity, and about 40 percent of the women reported sexual activity. Men were 1.3 times and women 1.4 times more likely to report a loss of sexual activity after one year if they didn't receive information on when to resume sexual activity.

"Sexuality is an important part of life throughout life, and most heart attack patients are sexually active" said Stacy Tessler Lindau, M.D., lead author of the study and associate professor of obstetrics/gynecology and medicine-geriatrics at the University of Chicago. "For the most part, physicians just aren't discussing this topic with their patients after a heart attack."

Most participants were assessed at one month and again at one year following their heart attack regarding level of sexual activity both before and after heart attack. Researchers set up gender-separate models to predict the frequency of sexual activity at one year following a heart attack in those who were sexually active prior to or since their heart attack. Male participants (average age 59 years) were more likely to be married than women participants (average age 61 years) and were more likely to be sexually active prior to the heart attack. Even after adjusting for these differences, patients who had been given instructions about resuming sexual activity at hospital discharge were more likely to engage in such activity over the following year.

The study was part of TRIUMPH (Translational Research Investigating Underlying Disparities in Recovery from Acute Myocardial Infarction: Patients' Health Status). Participants were asked questions about their sexual activity prior to and after having a heart attack.

"As survival after a heart attack continues to improve, it is important to begin studying the outcomes of patients who survive; their symptoms, function and quality of life," said John A. Spertus, M.D., M.P.H., Clinical Director of Outcomes Research at Saint Luke's Mid America Heart Institute/UMKC and Principal Investigator of the TRIUMPH Study. "To date, few studies have examined whether patients who survive a heart attack resume sexual activity."

"Little is known about what happens to patients' sexuality and sexual function after a heart attack, particularly for women" Lindau said. "While most hospitals have a regimented process of presenting discharge information to patients after heart attack, the question of when it's safe to resume sexual activity after heart attack is not always addressed."