AB50. Sex and the heart

Significant proportion of men with erectile dysfunction (ED) has asymptomatic ischemic heart disease (IHD). This is probably because comparatively smaller arteries in the penis (1-2 mm in diameter) become symptomatic before larger coronary arteries (3-4 mm in diameter). Studies have revealed that up to three-quarters of all men with consistent ED can expect to suffer a heart attack or stroke within five years unless their risk factors are modified. Diabetes, high blood pressure, hyperlipidaemia, obesity, sedentary life style, smoking are some of the common risk factors for ED and IHD. The link between the two conditions is endothelial dysfunction and atherosclerosis. In addition, long standing untreated ED, irrespective of its cause can lead to depression which has shown to be a risk factor for IHD. IHD is not a contra indication for sex. Sexual activity is another form of exercise, typical maximum workload with the established partner during sexual intercourse is about 3.3-3.4 MET’s. If the patient can achieve 5-6 MET’s without significant ischemia, arrhythmia or fall in blood pressure they are not at risk during normal sexual activity. Most of the reported deaths during sexual activity have happened in unfamiliar settings with an unfamiliar partner after heavy meals and alcohol. Recognizing the relationship between ED and IHD will improve and save lives. With proper medical management and life style modification risk factors can be corrected to improve erectile function and prevent IHD.