Few Receive Evidence-based Counseling About Sex After Myocardial Infarction
Key clinical point: Most patients, especially women, do not receive guidelines-based counseling about sexual activity following acute myocardial infarction.
Major finding: 12% of women and 19% of men reported having a discussion with their doctor about sex after AMI, with female gender being significantly associated with no counseling.
Data source: A prospective, longitudinal study of 2,349 women and 1,152 men with AMI aged 18-55 years in the United States and Spain.
Disclosures: The study was supported by grants from the National Institutes of Health and the Fondo de Investigacion Sanitaria del Salud Carlo III. The authors disclosed relationships with Medtronic, UnitedHealth, AstraZeneca, Bayer, and numerous other pharmaceutical companies.
FROM CIRCULATION
Among patients whose doctor issued restrictions on sexual activity, 35% were advised to limit sex, 26% to take a passive role, and 23% to keep heart rate down.
Female sex was significantly associated with no counseling (relative risk, 1.07), as was older age (RR, 1.05) and sexual inactivity at baseline (RR, 1.11). Women in Spain were significantly more likely than women in the United States to be advised to restrict sexual activity (RR, 1.36).
Guidelines from the American College of Cardiology, American Heart Association, and European Society of Cardiology all recommend that physicians counsel patients about sexual activity, and that sex can be resumed as long as the patient is able to tolerate mild to moderate physical activity.
“Physicians could meaningfully narrow the gap between guidelines and practice by adding permission to resume sex to routine counseling about returning to work and exercise,” the authors said. Using patient-centered tools to incorporate this into practice “could help improve outcomes and quality of life for younger women and men with AMI,” they added.
The study was supported by grants from the National Institutes of Health and the Fondo de Investigacion Sanitaria del Salud Carlo III. The authors disclosed relationships with Medtronic, UnitedHealth, AstraZeneca, Bayer, and numerous other pharmaceutical companies.
