American Heart Association: Most patients don’t receive counseling about resuming sexual activity after having a heart attack, and often when healthcare providers did counsel about sexual activity,
they recommended restrictions that were more conservative than medical
guidelines, according to new research in the American Heart Association journal Circulation.
Researchers interviewed 3,501 heart attack patients in 127 hospitals
and one month later by telephone in August 2008-January 2012 in the
United States and Spain. The patients’ median age was 48 years and
two-thirds were female.
One month after their heart attacks, only 12 percent of women and 19 percent of men reported they received sexual counseling from their healthcare provider — though most reported they were sexually active within the year before their heart attack.
“Even with life-threatening illness, people value their sexual
function and believe it is appropriate for healthcare providers to raise
the issue of resuming sexual activity,” said Stacy Tessler Lindau,
M.D., M.A.P.P., study lead author, associate professor of obstetrics and
gynecology and geriatric medicine and director of the Program in
Integrative Sexual Medicine at the University of Chicago Medical Center.
In rare instances when healthcare providers counseled about sexual
activity, they often recommended restrictions more conservative than
medical guidelines. For example, those patients given restrictions were
most often told to limit sex (35 percent), take a more passive role (26
percent), and/or keep their heart rate down (23 percent).
“Healthcare providers should let their patients know that for most it
is OK to resume physical activity, including sexual activity, and to
return to work,” Lindau said. “They can tell their patients to stop the
activity and notify them if they experience chest pain, shortness of
breath or other concerning symptoms. If the healthcare provider doesn’t
raise the issues, I encourage patients to ask outright: ‘Is it OK for me
to resume sexual activity? When? Is there anything I should look out
for?’”
In the United States and worldwide, heart disease is the leading
cause of death. About 720,000 people have a heart attack in the United
States each year and about 20 percent are 18-55 years old.
In 2013, the American Heart Association published a scientific statement about counseling patients with cardiovascular disease about sexual activity.
The statement concluded that sexual counseling should be tailored to
the individual needs and concerns of cardiovascular patients and their
partners/spouses
“When the topic of sexual function is left out of counseling,
patients perceive that it’s not relevant to their medical condition, or
that they are alone in the problems they have resuming normal sexual
activity,” Lindau said.
Co-authors are Emily M. Abramsohn, M.P.H.; Héctor Bueno, M.D., Ph.D.;
Gail D’Onofrio, M.D., M.S.; Judith H. Lichtman, Ph.D., M.P.H.; Nancy P.
Lorenze, D.N.Sc., M.S.N.; Rupa Mehta Sanghani, M.D.; Erica S. Spatz,
M.D., M.H.S.; John A. Spertus, M.D., M.P.H.; Kelly Strait, M.S.; Kristen
Wroblewski, M.S.; Shengfan Zhou, M.S. and Harlan M. Krumholz, M.D.,
M.S. Author disclosures are on the manuscript.
The study was funded by the National Institute on Aging; the National
Heart, Lung, and Blood Institute; Fondo de Investigaciones Sanitarias
del Instituto Carlos III, Ministry of Science and Technology; and the
Centro Nacional de Investigaciones Cardiovasculares.
Save the date: On December 16, 2014, from 10 a.m. – 2
p.m. CT, the American Heart Association/American Stroke Association
Support Network will be hosting a live online chat with medical experts
about intimacy after heart disease or stroke. Join the Support Network
now to ask your questions: http://supportnetwork.heart.org/conversations/viewtopic/59/599?post_id=1565#p1565