Sexual activity and concerns in people with coronary heart disease from a population-based study

Abstract

Objective Sexual activity is a central component of intimate relationships, but sexual function may be impaired by coronary heart disease (CHD). There have been few representative population-based comparisons of sexual behaviour and concerns in people with and without CHD. We therefore investigated these issues in a large nationally representative sample of older people. Methods We analysed cross-sectional data from 2979 men and 3711 women aged 50 and older from the English Longitudinal Study of Ageing. Sexual behaviour and concerns were assessed by validated self-completion questionnaire and analyses were weighted for non-response. Covariates included age, partnerships status and comorbidities. Results There were 376 men and 279 women with CHD. Men with CHD were less likely to be sexually active (68.7% vs 80.0%, adjusted OR 0.62, 95% CI 0.47 to 0.81), thought less about sex (74.7% vs 81.9%, OR 0.72, CI 0.54 to 0.95), and reported more erectile difficulties (47.4% vs 38.1%, OR 1.46, CI 1.10 to 1.93) than men without CHD. Effects were more pronounced among those diagnosed within the past 4 years. Women diagnosed <4 years ago were also less likely to be sexually active (35.4% vs 55.6%, OR 0.44, CI 0.23 to 0.84). There were few differences in concerns about sexual activity. Cardiovascular medication showed weak associations with erectile dysfunction. Conclusions There is an association between CHD and sexual activity, particularly among men, but the impact of CHD is limited. More effective advice after diagnosis might reverse the reduction in sexual activity, leading to improved quality of life.

Management of patients after primary percutaneous coronary intervention for myocardial infarction

“…28 A recent longitudinal study found no association between the use of β blockers and erectile dysfunction. 28 It is safe to prescribe phosphodiesterase type 5 inhibitors (such as sildenafil, vardenafil, and tadalafil) in patients with erectile dysfunction who have stable disease after myocardial infarction.…”

“…28 A recent longitudinal study found no association between the use of β blockers and erectile dysfunction. 28 It is safe to prescribe phosphodiesterase type 5 inhibitors (such as sildenafil, vardenafil, and tadalafil) in patients with erectile dysfunction who have stable disease after myocardial infarction. 27 A US guideline recommends that nitrate medications should be avoided within 24 hours of taking sildenafil or vardenafil and within 48 hours of taking tadalafil based on a small randomised trial.…”

Effects of Saffron Aqueous Extract and Its Main Constituent, Crocin, on Health-Related Quality of Life, Depression, and Sexual Desire in Coronary Artery Disease Patients: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial

“…CAD deeply affects sexual function in both men and women (34,35), while sex is the basis of intimate relationships. Reduced sexual activity and satisfaction, erection problems, and orgasmic problems have been described in these patients (36).…”

Coronary heart disease and sexual activity

“…In their Heart publication, Steptoe et al 9 report an elegant study whereby cross-sectional data from 2979 men and 3711 women aged 50 and older from the English Longitudinal Study of Ageing are presented. Sexual behaviour with a partner spouse (of either gender: 93.6% of men and 94.7% of women, heterosexual only) and their concerns were assessed by a validated self-completion questionnaire, and analyses were weighted for non-response with covariates including comorbidities, age and drugs.…”

“…Steptoe et al 9 have excluded patients who did not have CHD (defined as a doctor diagnosis of MI or angina pectoris) but had a history of stroke or heart failure. The natural history of these conditions and a possible different aetiology may justify their exclusion.…”