Sex does not increase heart attack risk, researchers find

Birth control pills pose small but significant stroke risk

SEX is rarely the cause of a heart attack, and most heart disease patients are safe to resume sexual activity after a heart attack, according to a research letter published yesterday in the Journal of the American College of Cardiology.

Sexual activity can be a concern for many heart attack patients who worry about exertion triggering another heart event, but data on the harms and benefits of sexual activity in heart disease patients is limited. According to the research letter, sexual activity generally involves moderate physical activity comparable to climbing two staircases or taking a brisk walk.

Researchers looked at 536 heart disease patients between 30 and 70 years old to evaluate sexual activity in the 12 months before a heart attack and estimate the association of frequency of sexual activity with subsequent cardiovascular events, including fatal heart attack, stroke or cardiovascular death.

In a self-reported questionnaire, 14.9 percent of patients reported no sexual activity in the 12 months before their heart attack, 4.7 percent reported sex less than once per month, 25.4 percent reported less than once per week and 55 percent reported one or more times per week. During 10 years of follow up, 100 adverse cardiovascular events occurred in patients in the study. Sexual activity was not a risk factor for subsequent adverse cardiovascular events.

Researchers also evaluated the timing of the last sexual activity before the heart attack. Only 0.7 percent reported sex within an hour before their heart attack. In comparison, over 78 percent reported that their last sexual activity occurred more than 24 hours before the heart attack.

Meanwhile, birth control pills cause a small but significant increase in the risk of the most common type of stroke, according to a comprehensive report in the journal MedLink Neurology.

For healthy young women without any stroke risk factors, the risk of stroke associated with oral contraceptives is small. But in women with other stroke risk factors, “the risk seems higher and, in most cases, oral contraceptive use should be discouraged,” report co-authors Marisa McGinley, DO; Sarkis Morales-Vidal, MD; and Jose Biller, MD of Loyola University Medical Center and Loyola University Chicago Stritch School of Medicine, United States.

Worldwide, more than 100 million women currently use oral contraceptives or have used them in the past. In the United States, there are about 40 brands of oral contraceptives and 21 brands of emergency contraceptive pills.

Strokes associated with oral contraceptives were first reported in 1962. Early versions of the pill contained doses of synthetic estrogen as high as 150 micrograms. Most birth control pills now contain as little as 20 to 35 micrograms. None contain more than 50 micrograms of synthetic estrogen.

Oral contraceptives increase the risk of ischemic strokes, which are caused by blood clots and account for about 85 percent of all strokes. In the general population, oral contraceptives do not appear to increase the risk of hemorrhagic strokes, which are caused by bleeding in the brain.