Sex and Your Heart

Lynn Holland
/ CC BY-ND 2.0

Every so often, a medical research study just makes people smile.

This was the case a few weeks ago when the American Journal of Cardiology reported that men having sex twice a week had about half the risk of developing heart disease than those having sex once a month. This was independent of age or erectile dysfunction. Good news for some, bad news for others. How about you?

But before you head in to see your doctor about a new "prescription," let's think about what this study really means. It actually tells us something that isn't very surprising - sexual health is a barometer for overall health. The ability and desire to have sex point toward a capacity for greater physical activity, healthier relationships, and stronger social support. It turns out that our lives inside the bedroom tell us a lot about our lives outside of it. Our sexual fitness can be a symbol of our overall fitness and our risk for heart disease.

But there's more to it than just that. While sex may be a marker of good heart health, it is important to consider that for some people, sexual activity can actually put them at risk. The good news is that it is pretty unlikely - less than one percent of heart attacks are preceded by sexual activity. But we should think about sexual activity much like we think about other types of intense exercise. Swings in heart rate, blood pressure, and stress can increase the possibility of a cardiac event, but in the majority of cases, the activity itself is less of an issue than the underlying condition. For this reason, people who have known heart disease need to directly communicate with their physicians about whether sexual activity is safe or recommended. In some situations, a stress test may be considered before recommending sexual activity, much in the same way that similar tests can be used to help guide people who wish to start a substantial exercise regimen.

So where does sexual dysfunction fit into the picture? While less sex may be associated with more heart disease, we also know that erectile dysfunction in men and sexual dissatisfaction in women are associated with a higher risk of heart disease and peripheral vascular disease in the future. And rather than thinking of it as a "side effect" of other cardiovascular problems, erectile dysfunction in particular may be a symptom of future concerns.

The first step involves what is sometimes the most difficult medical intervention of all - a conversation. Talk to your doctor about your heart condition if you have one, and talk about your sex life even if you don't. Get more information about your level of risk and what might be appropriate and safe for you to do. This is also a good time to review your medications and make sure that they aren't bringing you down - unfortunately some blood pressure medications are well known to increase the risk of erectile dysfunction and decreased sex drive. Make sure that your doctor is part of the solution rather than contributing to the problem. And while the likelihood of having a heart attack while engaging in sexual activity is low, you may feel more reassured if you approach the issue head on. In the end, it may really just boil down to the same question:

"Do you feel lucky?"

- James Beckerman, MD, FACC

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Women’s and Men’s Heart Attack Symptoms: What’s the Difference?

Fractal Ken
/ CC BY 2.0

Women and men may come from Venus and Mars, but Heart Month should remind us all that we have more in common sometimes than we might think - particularly where our hearts are concerned. Heart disease remains the leading cause of death in women and men worldwide.

The statistics are eye-opening – one in three women will develop cardiovascular disease, and 1 in 17 women in the U.S. will have a heart attack or hospitalization for heart disease before age 60. For men, the numbers are similarly sobering – more than one in three adult males have some form of heart disease.

We are used to thinking about the telltale signs of heart attacks based upon many years of research and clinical observation of what men have experienced – chest discomfort, arm and back pain, and shortness of breath top the list. But more recently, doctors and their patients are recognizing that women may experience heart attacks differently.

Women may certainly experience chest pain, but they should also be on the lookout for less obvious symptoms, like nausea, indigestion, and palpitations in addition to shortness of breath and back pain,. In fact, nearly half of the women in one study had no chest pain at all during their heart attack. Fatigue and shortness of breath were the most common symptoms.

Whereas chest pain, shortness of breath, and fatigue are the most typical symptoms for men, these heart attack warning signs for women should be considered carefully.

Major symptoms prior to heart attack	Major symptoms during the heart attack
•Unusual fatigue	•Shortness of breath
•Difficulty sleeping	•Weakness
•Shortness of breath	•Unusual fatigue
•Indigestion	•Cold sweat
•Anxiety	•Dizziness

Cardiologists have a saying: "Time is muscle." The sooner that we identify a heart attack, the quicker we can treat it, preserve heart function, and increase the likelihood of a healthy recovery. But the clock starts ticking with you. If you notice symptoms that are new, increasing in frequency, getting worse, or occurring when you are at rest, seek medical attention and remind your health care provider that statistics unfortunately don’t lie.

- James Beckerman, MD, FACC

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The Mediterranean Diet - It's Nuts!

Metabolic syndrome is a group of risk factors, including high blood pressure, high blood sugar, high cholesterol levels, and fat in the midsection that increase one's risk of heart disease and diabetes. Diet, exercise, and medications have been shown to improve metabolic syndrome and lower the risk of these complications.

Currently a study called Prevención con Dieta Mediterránea (PREDIMEDD) has enrolled 9000 high-risk participants aged 55 to 80 years who are assigned to one of three interventions: Mediterranean diet with the provision of 1 L/week of virgin olive oil, Mediterranean diet with 30 g/day of mixed nuts, or a low-fat diet. This is a long-term, multi-center, randomized controlled clinical trial is designed to assess the effects of the Mediterranean diet on the primary prevention of cardiovascular disease. (Primary prevention means the prevention of a disease that the person has never had before. Compare this to secondary prevention which means preventing a person who is known to have high cholesterol and blockages in the arteries from having a heart attack).

Already data from 1224 participants in the study have shown that adhering to a Mediterranean diet supplemented with mixed nuts appears to provide benefit to individuals with the metabolic syndrome. Investigators observed a reduced prevalence of metabolic syndrome at one year among individuals adhering to the Mediterranean diet plus mixed nuts compared with those adhering to the traditional Mediterranean diet alone.

"The novelty of our findings is that a positive effect on metabolic syndrome was achieved by diet alone, in the absence of weight loss or increased energy expenditure," wrote lead investigator Dr Jordi Salas-Salvadó (University of Rovira i Virgili, Reus, Spain) and colleagues in the December 8/22, 2008 issue of the Archives of Internal Medicine. At the beginning of this study, nearly 62% of the participants met the criteria for metabolic syndrome. After one year the rate of metabolic syndrome dropped by nearly 13.7% in the patients assigned to the Mediterranean diet plus mixed nuts, 6.7% in those consuming a Mediterranean diet alone, and only 2% among those on the traditional low-fat diet. (Is there anyone left out there who still thinks the ill-advised, poorly researched, low-fat diet benefited anyone but the companies making carbohydrate-rich junk foods?)

The beneficial effects of the diet happened without an increase in exercise habits, calories burned, or weight loss and add to the evidence that diets enriched with nuts do not induce weight gain, noted the authors. This author does note however that the amount of nuts was limited to 30 grams a day, which is one ounce or about 2 tablespoons). The researchers aren't sure yet what caused the improvement, but think that the diet plus mixed-nuts intervention may have positive effects on insulin resistance. Another possibility is the diet's effects on other factors such as oxidative stress and its related inflammation in the blood vessels. Previous analysis of the data have shown that the Mediterranean diet coupled with nuts protects against oxidative damage and reduces cardiovascular risk factors better than a low-fat diet.

Source: Salas-Salvadó J, Fernández-Ballart J, Ros E, et al. Effect of a Mediterranean diet supplemented with nuts on metabolic syndrome status. Arch Intern Med 2008; 168: 2449-2458.


Take care,

Laurie

Related Topics:

• Metabolic Syndrome? Nuts!
• Go Nuts on Your Diet!

World Diabetes Day

Today is World Diabetes Day (11/14). Stop for a moment and think about these facts:

Every 10 seconds someone dies from diabetes-related complications. In that same time period two new individuals develop the disease.

Over 250 million people in the world have diabetes; in less than 20 years this number will reach 380 million.

More than 200 children develop type 1 diabetes a DAY. This type of diabetes is increasing in preschool children at a rate of 5% annually.

Type 2 diabetes has been reported in children as young as eight. Type 2 diabetes is becoming increasingly common in school-aged children as a result of obesity. Just a generation ago this was a disease of adulthood, called "adult-onset" diabetes.

Even controlling for other risk factors, people living with diabetes are twice as likely as those without diabetes to die from cardiovascular disease (heart attack and stroke).

If you have diabetes or are at risk for developing diabetes, or you are one of us whose lives have somehow been touched by diabetes, take a moment today to talk about diabetes with anyone who'll listen. We need to increase awareness of this disease in the same way that heart disease and breast cancer have been recognized.

For more information: http://www.worlddiabetesday.org/

Related Topics:

• Warning Signs of Diabetes
• Diabetes and Other Risks: Assess Yourself

Something Fishy

Did you know that the American Heart Association recommends adding fish to your diet at least twice a week? The American Diabetes Association recommends 2-3 three ounce servings of fish per week for people with diabetes. Fish is a source of quality protein, vitamins, and minerals, and fatty fish are high in the heart-healthy omega-3 fatty acids known as EPA and DHA. Omega-3 fatty acids (FA's) are known to reduce inflammation in the body; inflammation is now thought to play an important role in the development of heart disease. Omega-3 FA's are also thought to decrease the risk of developing other inflammation-related diseases, such as Alzheimer's and vascular dementia. These fats are thought to be "brain food" for developing children's minds and for maintaining brain health in adults.

A recent study of women who have type 2 diabetes found that higher fish intake was associated with a significant decrease in risk of developing heart disease over a 16 year period of follow up. The fatty fish include salmon, mackerel, and tuna. While other fish such as cod, flounder, talapia, shrimp and shellfish aren't high in omega-3 FA's, they are a great source of protein that is low in calories and fat per 3 ounce serving, as long as it's cooked in heart-healthy ways. These include broiling, baking, steaming, and grilling your seafood choices.

Think you'd like to eat more seafood but don't know where to start? Try WebMD's Health and Cooking Resource page or do a web search for the particular item you want to cook and recipes, such as "cod recipes" or "shrimp recipes" and see what you find. Look for recipes at web sites that are promoting a healthy lifestyle, such as Eating Well and Weight Watchers.

If you are concerned about food safety and our environment as I am, you may be aware of some of the issues that surround the seafood industry, such as over-fishing some species, the loss of fish that are unwanted but are caught in net fishing, and the environmental damage done by some fish-farming methods. If you'd like more information on eating fish in an environmentally friendly way, try these resources at the Monterey Bay Aquarium and the Environmental Defense Fund (EDF). The EDF site also has information about mercury in fish and how to avoid it, and a link to recipes. Both sites have printable pocket guides to assist you in making sustainable choices in the grocery store.

Try some healthy fish soon; your mind, heart, and waistline will thank you for it!

Take care,

Laurie

Related Topics:

• Antioxidants and Omega-3 Fats: Functional Foods to Boost Health
• The Great Fish Cook-Off