[Cardiovascular disease and sexuality].
Sexual activity corresponds to light to moderate physical exercise and entails no significant risk to the majority of patients with cardiovascular disease. In patients suffering from severe angina or chronic heart failure, however, sexual activity might trigger coital angina or cardiac decompensation necessitating hospitalization. Nevertheless, even for patients with coronary artery disease the absolute risk of having a heart attack or fatal event during sexual activity is extremely low. Due to systemic atherosclerosis and concomitant endothelial dysfunction the prevalence of sexual dysfunction is higher in patients with cardiovascular disease as compared to the general population. PDE-5 inhibitors can be safely used by many patients suffering from both, cardiovascular disease and sexual dysfunction as long as no concomitant medication with nitrates exists. The concomitant use of PDE-5 inhibitors and nitrates is strictly contraindicated because of the risk of life-threatening hypotension. It is therefore of utmost importance to ask patients presenting with coital angina about PDE-5 inhibitor intake before the administration of nitrate-based anti-ischemic therapies. The recommendations of the Princeton Consensus Conference provide a useful framework for risk stratification and counseling of patients with cardiovascular disease regarding sexual activity.
Klinik für Kardiologie, Universitätsspital Basel, Basel.
Otmar
O
Pfister
D000787:Angina Pectoris / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D003075:Coitus / Q000502:physiology; D000075202:Contraindications; D004347:Drug Interactions; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000503:physiopathology / Q000517:prevention & control; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D009566:Nitrates / Q000009:adverse effects / Q000627:therapeutic use; D058986:Phosphodiesterase 5 Inhibitors; D010726:Phosphodiesterase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D012307:Risk Factors; D055502:Secondary Prevention; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D020018:Sexual Dysfunctions, Psychological / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy
D009566:Nitrates; D058986:Phosphodiesterase 5 Inhibitors; D010726:Phosphodiesterase Inhibitors
Kardiologische Erkrankungen und Sexualität.