• AHA Scientific Statement

Sexual Activity and Cardiovascular Disease

A Scientific Statement From the American Heart Association

1. Glenn N. Levine, MD, FAHA, Chair; 
2. Elaine E. Steinke, RN, PhD, FAHA;
3. Faisal G. Bakaeen, MD; 
4. Biykem Bozkurt, MD, PhD, FAHA; 
5. Melvin D. Cheitlin, MD, FAHA; 
6. Jamie Beth Conti, MD; 
7. Elyse Foster, MD, FAHA; 
8. Tiny Jaarsma, RN, PhD, FAHA; 
9. Robert A. Kloner, MD, PhD; 
10. Richard A. Lange, MD, MBA, FAHA;
11. Stacy Tessler Lindau, MD; 
12. Barry J. Maron, MD; 
13. Debra K. Moser, DNSc, RN, FAHA;
14. E. Magnus Ohman, MD; 
15. Allen D. Seftel, MD; 
16. William J. Stewart, MD on behalf of the American Heart Association Council on Clinical Cardiology Council on Cardiovascular Nursing Council on Cardiovascular Surgery and Anesthesia, and Council on Quality of Care and Outcomes Research

Key Words:

• AHA Scientific Statements
• cardiovascular disease

Introduction

Sexual activity is an important component of patient and partner quality of life for men and women with cardiovascular disease (CVD), including many elderly patients.¹ Decreased sexual activity and function are common in patients with CVD and are often interrelated to anxiety and depression.^2,3 The intent of this American Heart Association Scientific Statement is to synthesize and summarize data relevant to sexual activity and heart disease in order to provide recommendations and foster physician and other healthcare professional communication with patients about sexual activity. Recommendations in this document are based on published studies, the Princeton Consensus Panel,^4,5 the 36th Bethesda Conference,^6–10 European Society of Cardiology recommendations on physical activity and sports participation for patients with CVD,^11–13 practice guidelines from the American College of Cardiology/American Heart Association^14–16 and other organizations,¹⁷ and the multidisciplinary expertise of the writing group. The classification of recommendations in this document are based on established ACCF/AHA criteria (Table).

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Table.

Applying Classification of Recommendation and Level of Evidence

Acute Cardiovascular Effects of Sexual Activity

Numerous studies have examined the cardiovascular and neuroendocrine response to sexual arousal and intercourse, with most assessing male physiological responses during heterosexual vaginal intercourse.^18–24 During foreplay, systolic and diastolic systemic arterial blood pressure and heart rate increase mildly, with more modest increases occurring transiently during sexual arousal. The greatest increases occur during the 10 to 15 seconds of orgasm, with a rapid return to baseline systemic blood pressure and heart …

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