Oh please, not the “sex causes heart attack” story again


Former Executive Editor, Harvard Health

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Sexual activity nearly triples the risk of having a heart attack, report researchers from Tufts University and the Harvard School of Public Health in yesterday’s Journal of the American Medical Association.

For anyone who is sexually active—especially anyone worried about his or her heart—that’s an eye-catching and fear-inducing finding. It’s a message reinforced by television (Downton Abbey, Mad Men, and Rescue Me are just a few series that have used heart attack after sex as a plot device). But before you swear off sex forever, realize that “triples” refers to the relative risk. It’s calculated like this: A day or two day after having a heart attack, an individual is asked to recount all of the things he or she had done in the hours before the attack. Then as a “control,” the person is asked to list what he or she had done the day before (a day without a heart attack). The various activities on the heart attack day are compared with those on the non-attack day to calculate the relative risk.

But the relative risk isn’t nearly as important as the absolute risk. Here’s a calculation by Dr. James E. Muller, a cardiologist at Harvard-affiliated Massachusetts General Hospital, in an earlier article about sex and heart attack. The absolute risk of heart attack for a 50-year-old man who exercises regularly is 1 chance in a million per hour. Tripling that risk by engaging in sexual activity boosts it to 3 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. What’s more, in the JAMA study the chances of having a sex-related heart attack was lower in people who regularly exercised than it was among those who rarely exercised.

When sex is classified as a form of physical exertion, it’s pretty far down there in the mild to moderate intensity category. Sexual activity averages 2 to 3 metabolic equivalents (METs), a measure of energy expenditure, and may go up to 3 to 4 METs at orgasm. In comparison, walking slowly on level ground or doing light housework clocks in at 2 METs; climbing stairs, 3 to 4 METs; shoveling light snow, 6 to 7 METs.

The numbers for sexual activity are averages, of course. Sexual positions affect the potential effects on the heart. A study published in the Archives of Internal Medicine showed greater energy expenditure during sexual intercourse for both partners with the man on top (2.0 to 5.4 METs) than with the woman on top (2.5 to 3.0 METs). And sex with a new partner in an unfamiliar setting increases the relative risk more than sex with a familiar partner in a familiar setting.

The good news from this study is that sex is a relatively rare trigger of heart attack or sudden death—even less than shoveling snow. The even better news is that regular physical activity, like walking or having sex, reduces the relative risk of having a heart attack while exercising or having sex by five-fold or more, according to the JAMA study. Factor in the fact that regular physical activity improves sexual function, and it’s amazing that walking trails, cycling routes, and other exercise venues aren’t always mobbed.

To learn more about the benefits of exercise, take a look at “Exercise: A program you can live with” a Special Health Report from Harvard Health Publishing. Click here to see the contents and read an excerpt.


  1. Farly

    What the meaning “Sexual activity averages 2 to 3 metabolic equivalents (METs), a measure of energy expenditure, and may go up to 3 to 4 METs at orgasm” could you explain?

  2. Michele

    as we know that sex with a new partner in an unfamiliar setting increases the relative risk more than sex with a familiar partner in a familiar setting.

  3. dewa perkasa

    nice info

  4. Daniel

    Is the heart attack triggered by physical sexual activity, or the orgasms themselves. Like women or men using Adult Toys to achieve sexual release?

  5. J. Braian Van

    Hey, Female or male sex affect the intensity of their desires. Is normal. However, in some cases the desire to have more, but not the intensity of tattoo fauna problems which may emerge.

  6. John Gilmore

    Sex can cause a heart attack, hmm I thought it would be good for the heart but I guess not since the heartbeat will raise.
    Thanks for the information
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  7. naya

    have heard about it many times before but i always think that this is kind of bogus news. but after reading this information, i was just thinking that it could be true.

  8. Wayne

    If sex does cause a heart attack, that is really the best way to go.
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  9. Toii

    Sexual intercourse is a very important part of life, we can’t go around being afraid of dying from it.

    [URL removed by moderator] that’s just insane. You guys need to study this in further detail lots of people have active lives. Also being that these tests are in America Land of the fast food and the free people may not be doing as well as they could in other countries.

    Life is great!!!!!

  10. John

    You made me laugh guys. What kind of statistic is that? You can ask 60-year-old men who ran 3 miles before they had heart attacks. It will increase your rate too!!!

    If you don’t care of your heart of course any physical activity will lead you to a heart attack.

    I’m a 52-year-old athlete (former swimmer), my wife is 38 years old. We make love every day. And I don’t feel if my heart is ever going to stop. My blood pressure is 130-85, cholesterol is normal too, sugar, you name it, coz I still go swimming 3 times a week!

    I enjoy every day of my life!

  11. Robert Saunders

    I personally believe sex is good for the heart, however there is a difference between sex and sexual addiction.
    To repeat the popular saying “Too much of a good thing is probably going to be bad”
    Sex itself provides mild aerobic activity for the human body, aerobic activity has been shown to be good for the heart. So therefore we could conclude sex would be good for the heat.
    However a sexual addiction or Porn addiction could be detrimental to the heart some experts claim, however more research should be done in these topics before we can state anything factually.

    Robert Saunders
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  12. Mark

    I wonder if addiction to pornography (and its subsequent action, typically masturbation) falls within the same category of the sexual activity that triples the risk of heart attack. Recent stats show that a very high number of the population, mostly males, spend prolonged hours watching porn online and acting out.. would be interesting if such a research can cover masturbation and pornography.. sorry for being graphic.

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