Heart Rate and Blood Pressure Response in Adult Men and Women During Exercise and Sexual Activity

doi:10.1016/j.amjcard.2007.07.040

The American Journal of Cardiology

Volume 100, Issue 12, 15 December 2007, Pages 1795-1801

https://doi.org/10.1016/j.amjcard.2007.07.040 Get rights and content

The purpose of this study was to assess the heart rate (HR) and blood pressure (BP) response of sexual activity compared with treadmill exercise in adult men and women. Nineteen men, 55 ± 8 years, and 13 women, 51 ± 7 years, underwent a maximal Bruce protocol treadmill stress test followed by home-monitored sexual activity using noninvasive HR and BP recording devices. The mean treadmill times were significantly shorter than the mean times of sexual activity for men and women (p <0.001 and p = 0.002, respectively). For the men, average maximum HR, systolic BP, and HR–BP product during sexual activity were 72%, 80%, and 57% of respective measurements during treadmill exercise. For the women, maximum HR, systolic BP, and HR–BP product during sexual activity were 64%, 75%, and 48% of respective measurements during treadmill exercise. Age correlated inversely with duration of treadmill exercise (a 9-second decrease in duration per increasing year of age; p = 0.036), and with the duration of sexual activity (a 1-minute decrease in duration per increasing year of age; p = 0.024). Treadmill exercise duration predicted sexual activity duration (a 2.3-minute increase in sexual activity duration per each minute treadmill duration; p = 0.026). In conclusion, sexual activity provides modest physical stress comparable with stage II of the standard multistage Bruce treadmill protocol for men and stage I for women.

Section snippets

Methods

Study participants were solicited from the outpatient cardiology department of the University of Medicine and Dentistry of New Jersey, including staff, patients, and their partners. Sexually active men and women, 40 to 75 years old, were invited to participate. Exclusion criteria were hospitalization in the preceding 3 months, or inability to perform or an ischemic response to treadmill exercise. All participants continued prescribed medications. After signing informed consent, study

Results

Of 39 adults enrolled in the study, 7 were eliminated because of technically inadequate BP recordings during sexual activity. The final study sample was 32, including 19 men (55 ± 8 years), and 13 women (51 ± 7 years) (Table 1). The men had more overt heart disease than the women.

Table 2 lists the hemodynamic characteristics during the participants’ treadmill exercise and sexual activity. Treadmill times were significantly shorter than the duration of sexual activity. The maximum HR, systolic

Discussion

Sexual activity was a modest physical stress comparable to stage II of the standard multistage Bruce treadmill protocol for men and stage I for women. This study confirms and extends previous studies by enrolling a more heterogeneous sample of older men and the largest cohort of women, by using less obtrusive noninvasive HR and BP monitoring devices, and by making direct comparisons between participants’ perceived level of exertion during maximal treadmill exercise and usual sexual activity (

References (12)

B.L. Johnston et al.
Dynamic electrocardiographic recording during sexual activity in recent post-myocardial infarction and revascularization patients
Am Heart J
(1979)
E.D. Nemec et al.
Heart rate and blood pressure responses during sexual activity in normal males
Am Heart J
(1976)
Y. Drory et al.
Myocardial ischemia during sexual activity in patients with coronary artery disease
Am J Cardiol
(1995)
W.H. Masters et al.
Human Sexual Response
(1966)
V. Masini et al.
Dynamic electrocardiogram in normal subjects during sexual activity
G Ital Cardiol
(1980)
H.K. Hellerstein et al.
Sexual activity and the postcoronary patient
Arch Intern Med
(1970)

There are more references available in the full text version of this article.

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Frequency of Sexual Activity and Long-term Survival after Acute Myocardial Infarction
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Sexual activity is an important element of normal human function, well-being, and quality of life.1–3 It is considered a form of physical activity because it requires stretching and physical movement.4,5 Several cohort studies have examined the relationship between sexual activity and mortality risk in the general population, mostly demonstrating an inverse association.6–9
Previous studies have shown an inverse relationship between sexual activity and mortality in the general population. We evaluated the association between sexual activity and long-term survival among patients with acute myocardial infarction.
Patients aged ≤ 65 years (n = 1120; mean age, 53) discharged from 8 hospitals in central Israel after first myocardial infarction from 1992-1993 were followed for mortality through 2015. Frequency of sexual activity was self-reported during the index hospitalization (baseline; referring to the year preceding the infarct) and after 5 and 10-13 years, along with sociodemographic and clinical data. Cox proportional hazards models were constructed to estimate the association with all-cause mortality in time-dependent sexual activity categories.
At baseline, a > once per week frequency of sexual activity was reported by 42% of the patients, whereas no sexual activity was reported by 6%. After 10-13 years, the rates were 21% and 27%, respectively. Lower sexual activity was associated with older age, female sex, lack of a steady partner and more comorbidities. During follow-up, 524 deaths (47%) occurred. An inverse relationship was observed between sexual activity frequency and death, with hazard ratios (95% confidence intervals) of 0.30 (0.23-0.38) for > once per week, 0.36 (0.28-0.46) for once per week, and 0.53 (0.42-0.66) for < once per week, compared with none. After adjusting for relevant confounding factors, the estimates were attenuated to 0.68 (0.50-0.91), 0.63 (0.48-0.83), and 0.72 (0.57-0.93), respectively (P for trend = .004).
Using repeated assessments of sexual activity after myocardial infarction, an inverse association was demonstrated with mortality, which was only partly accounted for by measured potential confounders.
Sexual Activity and Heart Patients: A Contemporary Perspective
2016, Canadian Journal of Cardiology
Citation Excerpt :
As early as 1932, Boas and Goldschmidt reported heart rate (HR) changes during coitus by using a rudimentary cardiotachometer,42 which was linked by 100-ft cables to 3 electrodes placed on the participant's chest. Since then, several better controlled studies have subsequently been reported using primarily married couples who engaged in intercourse in their habitual bedroom as participants.14,43-50 These studies considered different types of SA, from self-masturbation to intercourse, as well as distinct male and female body positions during penetration.
Sexual activity (SA) encompasses several behaviors such as kissing (Ki), touching (T), oral (O) stimulation, masturbation (M), and vaginal/anal intercourse (I). The acronym KiTOMI is proposed here to represent these behaviors. SA, particularly coitus, is a major aspect of health-related quality of life and is often considered the most pleasant and rewarding exercise performed during an entire lifetime. Although several studies have been conducted on sexuality, relatively limited information is available regarding SA in patients with heart disease. Moreover, the level of evidence of this limited information is nearly always B or C. This article provides a comprehensive and updated review of the relevant literature and offers evidence and expert-based practical messages regarding SA in patients with heart disease. Considering the rationale for exercise prescription, SA is typically well tolerated by most clinically stable patients with heart disease. Even in more debilitated and sicker individuals, KiT activities would most likely be feasible and desirable. The absolute risk of major adverse cardiovascular events during SA is typically very low. Even lower death rates have been reported for specific groups, such as women in general, aerobically fit men, and asymptomatic young adults with congenital heart disease. Finally, we emphasize the relevance of sexual counselling for patients and their partners, including the proper use of medications to treat erectile dysfunction. Counselled patients will be reassured and adequately informed regarding how to gradually resume habitual SA after a major cardiac event or procedure, starting with KiT and progressively advancing to KiTOM until all KiTOMI activities are allowed.
L’activité sexuelle se décline en plusieurs comportements, notamment le fait de s’embrasser (kissing – Ki), de se toucher (T), d’avoir un contact oral (O), de se masturber (M) et d’avoir un rapport vaginal ou anal (intercourse – I). L’acronyme KiTOMI, tiré de la terminologie anglaise, est proposé ici pour représenter l’ensemble de ces comportements. L’activité sexuelle, et plus particulièrement le coït, est un aspect important de la qualité de vie liée à la santé et est souvent citée comme l’activité la plus plaisante et la plus gratifiante de toute une vie. Plusieurs études ont été effectuées sur la sexualité, mais nous ne possédons que très peu d’information sur l’activité sexuelle des patients atteints d’une maladie cardiaque et la qualité de ces données est généralement de niveau B ou C. Cet article vous offre une revue détaillée et à jour de la documentation médicale pertinente, en plus de fournir des preuves factuelles et des suggestions pratiques de la part de spécialistes au sujet de l’activité sexuelle à l’intention des personnes souffrant d’une maladie cardiaque. L’activité physique étant encouragée chez ces patients, l’activité sexuelle est en général bien tolérée par la plupart des patients atteints d’une maladie cardiaque dont l’état est stable sur le plan clinique. En fait, même chez les personnes les plus affaiblies et malades, le fait de se toucher et de s’embrasser est habituellement possible et tout à fait souhaitable. En effet, le risque d’être victime d’un événement indésirable grave de nature cardiovasculaire au cours d’une activité sexuelle est en fait très faible. De plus, le risque de mortalité est plus faible encore chez les femmes en général, les hommes ayant une bonne capacité aérobique et les jeunes adultes atteints d’une cardiopathie congénitale, mais asymptomatiques. L’article met également l’accent sur l’importance, tant pour les patients que pour leurs partenaires, d’être bien conseillés en matière de sexualité, y compris sur la prise adéquate des médicaments destinés à traiter le dysfonctionnement érectile. Il est important que les patients soient informés et rassurés sur la reprise graduelle de leurs activités sexuelles suivant un événement cardiaque grave ou une importante intervention cardiaque. Ils pourront ainsi reprendre tout doucement leurs activités sexuelles en renouant avec le toucher et les baisers, progresser ensuite à la stimulation orale et à la masturbation pour finalement en arriver à la reprise des relations sexuelles complètes.
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Pharmacological rewards, such as drugs of abuse, evoke physiological stress responses, including increased heart rate and blood pressure, and activation of the hypothalamic–pituitary–adrenal (HPA) axis. It is not clear to what extent the natural reward of palatable foods elicits similar physiological responses. In order to address this question, HPA axis hormones, heart rate, blood pressure and brain pCREB immunolabeling were assessed following novel and repeated sucrose exposure. Briefly, adult, male rats with ad libitum food and water were given either a single (day 1) or repeated (twice-daily for 14 days) brief (up to 30 min) exposure to a second drink bottle containing 4 ml of 30% sucrose drink vs. water (as a control for bottle presentation). Sucrose-fed rats drank more than water-fed on all days of exposure, as expected. On day 1 of exposure, heart rate, blood pressure, plasma corticosterone, and locomotion were markedly increased by presentation of the second drink bottle regardless of drink type. After repeated exposure (day 14), these responses habituated to similar extents regardless of drink type and pCREB immunolabeling in the hypothalamic paraventricular nucleus (PVN) also did not vary with drink type, whereas basolateral amygdala pCREB was increased by sucrose intake. Taken together, these data suggest that while sucrose is highly palatable, physiological stress responses were evoked principally by the drink presentation itself (e.g., an unfamiliar intervention by the investigators), as opposed to the palatability of the offered drink.
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: This study was supported by an independent medical grant from Pfizer, Inc., New York, New York.

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MiscellaneousHeart Rate and Blood Pressure Response in Adult Men and Women During Exercise and Sexual Activity

Section snippets

Methods

Results

Discussion

Am Heart J

Am Heart J

Am J Cardiol

Human Sexual Response

Dynamic electrocardiogram in normal subjects during sexual activity

G Ital Cardiol

Sexual activity and the postcoronary patient

Arch Intern Med

Miscellaneous
Heart Rate and Blood Pressure Response in Adult Men and Women During Exercise and Sexual Activity