Sex after heart attacks 'not the preserve of mad men'

12 , May , The Telegraph

Salacious plot lines where middle-aged men die in their lovers' arms are putting heart attack survivors off sex, say doctors. Television series like Downton Abbey and Mad Men, and films like Body of Evidence, feature dramatic scenes where philandering men suffer heart attacks in bed brought on by the exertion and excitement of it all.

But cardiologists say heart attacks are so rarely brought on by sex that survivors need not abstain.Less than one per cent of people who die due to fatal heart attacks do so during or shortly after sex, they say.

According to the American Heart Association, anyone fit enough to walk up a few flights of stairs should be fit enough to have sex, as they are equally strenuous.PJ Skerrett, senior editor of Harvard Health, said the overblown message that sex triggered heart attacks was "reinforced by television".

"Downton Abbey and Mad Men are just a few series that have used heart attck after sex as a plot device," he commented.In Downton Abbey, Lady Mary, played by Michelle Dockery, is left aghast when a Turkish diplomat dies in her bed after they have made love.Scandal is only averted by the abbey's womensfolk, who conspire to move him in the middle of the night to his own bed.In Mad Men, advertising boss Roger Sterling suffers a heart attack after spending the night with a pair of twins, whom he shares with a colleague, Don Draper. He survives, and the experience does not change him.In Body of Evidence, Madonna stars as a woman accused of having rough sex with an elderly millionaire to kill him and inherit his fortune.

Last year the sex-triggers-heart-attacks theory was given scientific backing by a study, published in the Journal of the American Medical Association. It found that heart attack risk was almost three times higher in the hour or two after sex than at other times.But Skerrett said the absolute risk of suffering a heart attack due to sex was very low indeed.

Writing in a blog, he said a cardiologist called Dr James Muller of Massachusetts General Hospital had calculated the risks.Skerrett sumarised: "The absolute risk of heart attack for a 50-year-old man who exercises regularly is one chance in a million per hour."Tripling that risk by engaging in sexual activity boosts it to three in one million per hour, and only for the two-hour period during and after sexual activity."For a heart attack survivor who is getting back into shape, the absolute risk of 10 in one million per hour increases to 30 in one million per hour."In other words, sex can trigger a heart attack, but it doesn't happen very often."

A new study, published in the American Journal of Cardiology, has found that far too few cardiologists give heart attack survivors advice on resuming their sex lives.The survey of 1,879 heart attack patients found less than half of men and about a third of women recalled receiving instructions about when it was safe to do so.Dr Stacy Tessler Lindau, of University of Chicago Medicine, said those who did not receive advice were far less likely to resume their sex lives than those who did.

She said: "Doctors need to understand the significant role they play in helping acute myocardial infarction [heart attack] patients avoid needless fear and worry about the risk of relapse or even death with return to sexual activity."Dr Harlan Krumholz, of Yale University School of Medicine, added: "This study may help doctors address issues that they're traditionally reluctant to discuss.

"We're showing that addressing sexual health may make a difference to long-term outcomes."The Department of Health advises that having sex poses "no increased risk" of a repeat heart attack."If you recover well after your heart attack, you can have sex again when you feel ready. This is usually after about four weeks," it states.But for those who think that this means heart attacks are not triggered by sex, might still be wrong.

Julian Fellowes, the author of Downton Abbey, revealed last autumn that the incident of the Turkish diplomat was based on a real event at the country house of a family friend, in about 1890.And philanderers should still beware.