Sexual activity can be safe in men with chronic heart failure

With proper screening and treatment, many patients with chronic heart failure can safely engage in sexual activity, according to a review published in the Mayo Clinic Proceedings (2007; 82:1203-10).

Researchers in the division of cardiology at Washington University in St. Louis conducted systematic independent literature reviews that focused on chronic heart failure, sexual activity, and sexual dysfunction.

One study of middle-aged men with and without coronary artery disease found that the peak heart rate during intercourse was lower than heart rates measured during the patients’ normal daily activities. The study participants’ peak oxygen consumption levels during intercourse were comparable to what they were during moderate activity.

The authors also addressed how to counsel and treat chronic heart failure patients who are coping with erectile dysfunction. Patients with chronic heart failure have blood vessel and circulation abnormalities that can reduce blood flow into the penis, and erectile dysfunction can be caused or worsened by many of the medications, such as nitrates, that are commonly prescribed to treat chronic heart failure. To further explore this potential risk, the authors reviewed results from studies in which male patients with congestive heart failure took sildenafil citrate (Viagra).

“Taken together, these studies show that erectile dysfunction in patients with mild to moderate chronic heart failure can be safely and effectively treated with sildenafil, provided that patients are appropriately screened before therapy,” the authors noted.

For those patients who cannot take erectile dysfunction medications, the authors note that an exercise training regimen may be an appropriate substitute therapy.