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Sexual Activity in Coronary Heart Disease Patients

Steptoe et al present a population based cross-sectional study to assess the relationship between sexual activity and coronary heart disease.



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.


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 nonresponse. Covariates included age, partnerships status and comorbidities.


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. Cardiovascularshowed weak associations with erectile


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.

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