Sex is safe for most heart patients, doctors say

Most heart and stroke patients whose conditions are stable can safely have sex, according to new U.S. guidelines.


The American Heart Association published the recommendations on sexual activity and cardiovascular disease on Thursday. The review by experts in heart disease, exercise physiology and sexual counselling concluded that people with stable symptoms generally have a low risk of heart problems with sexual activity.


The authors stress, however, that all heart patients should check with their doctor before resuming their sex life. Just as important, the guidelines encourage patients -- and their partners -- to discuss any feelings of sex-related anxiety or depression with a health professional.


The recommendations include:


It's reasonable for people diagnosed with cardiovascular disease to be evaluated by a physician or other health-care provider before resuming sexual activity.
Cardiac rehabilitation and regular physical activity can reduce the risk of cardiovascular complications related to sexual activity in people who have had heart failure or a heart attack.
Women with cardiovascular disease should be counselled on the safety and advisability of contraceptive methods and pregnancy based on their individual profile.
Patients should be assessed to see if their sexual dysfunction is related to underlying heart disease, anxiety, depression or other factors.
Drugs to treat erectile dysfunction are generally safe for men who have stable cardiovascular disease but should not be taken by those receiving nitrate treatment for chest pain due to blocked arteries.
The absolute risk of cardiovascular events is "miniscule" because sexual activity is short in duration and is estimated to cause less than one per cent of all heart attacks, the authors noted.


Last year, an analysis published in the Journal of the American Medical Association concluded that people who exercise regularly have a much smaller risk of having a heart attack immediately after sexual or physical activity.


The guidelines also include recommendations on sexual activity for other heart conditions such as heart failure, arrhythmias and pacemakers and heart conditions present at birth, as well as for estrogen replacement therapy after menopause and herbal medications.

Sex poses surprisingly low risk to heart patients

CHICAGO — Good news: Sex is safe for most heart patients. If you’re healthy enough to walk up two flights of stairs without chest pain or gasping for breath, you can have a love life.


That advice from a leading doctors’ group on Thursday addresses one of the most pressing, least discussed issues facing survivors of heart attacks and other heart patients.


In its first science-based recommendations on the subject, the American Heart Association says having sex only slightly raises the chance for a heart attack. And that’s true for people with and without heart disease.


Surprisingly, despite the higher risk for a heart patient to have a second attack, there’s no evidence that they have more sex-related heart attacks than people without cardiac disease.


Many heart patients don’t think twice about climbing stairs, yet many worry that sexual activity will cause another heart attack, or even sudden death, said Dr. Glenn Levine, lead author of a report detailing the recommendations and a professor of medicine at Baylor College of Medicine in Houston.


The risk of having a heart attack during sexual activity is two to three times higher than when not having sexual activity. However, this increased risk of heart attack during sexual activity represents only a very small part of a person's overall risk of having a heart attack, and sexual activity is the cause of less than 1 percent of all heart attacks," Levine said.
Among heart attack survivors, average risks for another heart attack or sudden death are about 10 in 1 million per hour; having sex increases that to about 20 to 30 in 1 million per hour of sexual activity, the new report says. People without heart disease face lower overall risks for a heart attack, but similar risks for a sex-related attack.
The updated advice was released online Thursday in the heart association journal, Circulation.
Dr. Keith Churchwell, chief medical officer of Vanderbilt University's Heart and Vascular Institute, said the guidance is important for patients, and that questions about sex are the most common ones he hears from heart patients.
Ohio State University heart specialist Martha Gulati praised the recommendations for emphasizing that sexual counseling is important not just for patients but also their partners, who she says are often just as nervous about resuming sexual activity.
Day-care operator Tammy Collins of Reynoldsburg, Ohio, one of Gulati's patients, says the advice is reassuring.
She had a heart attack last year on Sept. 11, during a trip to Cincinnati to celebrate her wedding anniversary.
Collins' mother died of a heart attack at the same age, on her 51st birthday. With high blood pressure and high cholesterol, Collins knew she was at risk. She developed symptoms a few hours after having sex. She dismissed it at first, until she felt a sharp pain in her upper back and had trouble breathing. She was rushed to the hospital and doctors used stents to open blocked arteries.
Collins said she wasn't embarrassed to ask Gulati about sex, who told her it was unlikely that her night of romance had caused the heart attack. After several weeks of cardiac rehab, she was cleared to resume sexual activity — advice that surprised her friends. But Collins said the exercise sessions have made her feel fitter than ever.
"A heart attack does not have to be the end of living," Collins said.
Chicago cardiologist Dan Fintel, a professor of medicine at Northwestern University, said he routinely gives heart patients a sex talk on their last day in the hospital, knowing that it's likely on their minds.
"Resuming sexual activity is safe and emotionally part of the healing process, with a few caveats," he tells patients.
Those caveats elicit nervous chuckles when he explains that includes no philandering, given evidence about that causing extra stress.

American Cancer Society Blogger Apologizes for Bald Barbie Flub

We haven't heard much about the flu this year -- but that doesn't mean it's not out there. Flu activity was "minimal" through early January, says the Centers for Disease Control and Prevention. But cases could still spike. It's not too late to get vaccinated.
A rare outbreak: Whether you call it "mass hysteria" or the less sensational "mass psychogenic illness," the outbreak of tics and vocal outbursts among a dozen teen girls in a New York town is a rare occurrence, experts say. And there's no need to worry teens nationwide will be affected by the publicity, they add: Such mass cases of "conversion disorder" only occur among closely-knit groups.
Mental health help: Most Americans with mental health problems get no professional help, a new government survey shows. Major reason: costs. About 1 in 5 adults reported mental health conditions in 2010, unchanged from 2009.


Andrew Becker, a director of media relations for the American Cancer Society, drew ire after posting a controversial blog post on the American Cancer Society’s website called ”Bald Barbie Demand Is an Over-Reach.” In the post, Becker said the Bald Barbie movement could “do more harm than good for kids and parents.”
“If they are mass marketed, many of these dolls will end up in the hands of girls who luckily aren’t likely to be touched by cancer in themselves or their mothers. But could they end up being terrorized by the prospect of it in a far outsized proportion to their realistic chances? There is no reason to create this sort of fear,” Becker wrote.
Outraged supporters of the Bald Barbie campaign took to the cancer society’s Facebook page, demanding that Becker be fired. Someone named Chanda called Becker’s blog post “callous talk.”
“There are little girls and little boys out there feeling like they no longer fit in – they no longer have children in their class they can relate to,” she wrote.
Becker took down his offending blog today and replaced it with an apology.
“When I set out to write, I wanted to raise questions about activism and social media around disease. I did not mean to imply that I or the American Cancer Society believes that sick children are not important,” he wrote.

Indonesia reports second bird flu death this year

The H5N1 virus also claimed the lives of a man in Vietnam and of a toddler in Cambodia this week.


The three deaths bring the total number of avian influenza fatalities in the region to five in the last three weeks.


A man diagnosed with China's first case of bird flu in more than a year died in Shenzhen on 31 December. A man died in Jakarta, Indonesia on 7 January.


It is believed that the 23-year-old was a family member of the toddler, and they were both in contact with sick pigeons.


In Vietnam tests confirmed that the 18-year-old man, who died on Monday, had contracted the disease, health officials said. This was the country's first bird flu death since April 2010.


He was working at a duck farm in Can Tho City in the Mekong delta. He came down with a high fever and developed problems.


The latest Indonesian victim lived in the same house with a 24-year-old relative who died of the virus on January 7 but authorities say there is no evidence of human-to-human transmission between the two infected people.
"The child passed away after being treated for a few days at a hospital," Tjandra Yoga Aditama, the head of communicable diseases at Indonesia's health ministry, told AFP.
"We have conducted several tests and the results showed that she contracted the same H5N1 avian influenza virus that was detected before, so the virus has not developed," he said.
The girl had contact with poultry around their neighbourhood, he said, but could not confirm whether she had contracted the virus from chickens or pigeons -- both found in her neighbourhood of Tanjung Priok in north Jakarta.
Indonesia has been the hardest-hit by bird flu, with 150 deaths reported between 2003 and 2011, according to the World Health Organization.
"With this case, the cumulative number of bird flu cases in Indonesia since 2005 has reached 184 cases, 152 of those ended in death," the health ministry said on its website.
Nine Indonesians died from the virus last year, including two children on the resort island of Bali in October.
The virus typically spreads from birds to humans through direct contact, but experts fear it could mutate into a form easily transmissible between humans, with the potential to kill millions in a pandemic.