Mayo Clinic Proceedings: Men with chronic heart failure can have active sex livesOctober 05, 2007ROCHESTER, Minn. -- Although medication can help extend the lives of men with chronic heart failure, several factors associated with this disease can interfere with a person's ability to engage in and enjoy sexual activities. Fatigue, depression, medication side effects and the fear of damaging the heart can cause people with chronic heart failure to lose interest in sex or wonder whether this activity is safe for them. A literature review published in the October issue of Mayo Clinic Proceedings finds that with proper screening and treatment, many patients with chronic heart failure can safely engage in sexual activity. Methods Co-authors Stacy Mandras, M.D., Patricia Uber, Pharm. D., and Mandeep Mehra, M.D., conducted systematic independent literature searches using the MEDLINE database and examined a broad range of medical research that focused on chronic heart failure, sexual activity and sexual dysfunction. This literature included data from patient surveys and clinical trials. Findings Many people with chronic heart failure worry that having sex will place too great a strain on the heart. To address this issue, Drs. Mandras and Mehra analyzed studies that showed the impact of sexual activity on heart rate, blood pressure and respiratory rates, which typically increase during sexual activity and other forms of exertion. One study the authors reviewed measured these changes in middle-aged men with and without coronary artery disease. This study found that the peak heart rate during intercourse was lower than heart rates measured during the patients' normal daily activities. The study participants' peak oxygen consumption levels during intercourse were moderate - comparable to their oxygen consumption levels during moderate activities such as walking on level ground at 3 to 4 miles per hour, climbing stairs slowly or doing general housework such as vacuuming. The authors also addressed how to counsel and treat chronic heart failure patients who are coping with erectile dysfunction, difficulty achieving or maintaining an erection. Researchers estimate that erectile dysfunction affects 60 percent to 70 percent of people who have chronic heart failure. The authors observe that multiple factors may be involved. In addition to decreased exercise capacity, patients with chronic heart failure have blood vessel and circulation abnormalities that can reduce blood flow into the penis and interfere with the ability to maintain an erection. And erectile dysfunction can be caused or worsened by many of the medications that are commonly prescribed to treat chronic heart failure. Currently, the preferred treatment for erectile dysfunction includes sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis). However, numerous experts have raised concerns about the use of these drugs in patients with chronic heart failure who also take nitrates (or other medications that relax and widen blood vessels). This drug combination has been shown to be dangerous, because it can increase the risk for a life-threatening drop in blood pressure. To further explore this potential risk, the authors reviewed results from a variety of studies in which male patients with congestive heart failure took sildenafil. The authors observed that more data are needed to determine the safety of the newer drugs, vardenafil and tadalafil, for these patients. "Taken together, these studies show that erectile dysfunction in patients with mild to moderate chronic heart failure can be safely and effectively treated with sildenafil, provided that patients are appropriately screened before therapy," say the authors. For those patients who cannot take erectile dysfunction medications, the authors counsel that an exercise training regimen may be an appropriate substitute therapy to enhance sexual function and quality of life. The authors stress that clinicians should focus on the sexual activity history of chronic heart failure patients and not ignore it, since addressing this element can substantially improve their quality of life. Mayo Clinic |
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| Related Heart Failure Current Events and Heart Failure News Articles Researchers develop innovative imaging system to study sudden cardiac arrest A research team at Vanderbilt University has developed an innovative optical system to simultaneously image electrical activity and metabolic properties in the same region of a heart, to study the complex mechanisms that lead to sudden cardiac arrest. Experts unveil new CVD guidelines and position papers Several new guidelines and position papers offering the most up to date information to ensure that clinicians practice evidence-based medicine were released at the Canadian Cardiovascular Congress 2009 this week. UT Southwestern patient first in North Texas to receive newest-generation heart failure device UT Southwestern Medical Center patient Michael LeBlanc, 40, is the first in North Texas to receive the newest generation of a mechanical device designed to improve heart function. It will be his lifeline while he awaits a heart transplant. Learning the risks for stroke - and taking action With this theme in mind, the European Society of Cardiology (ESC) emphasises that most of the risks for stroke are also the major risks for coronary heart disease - and thus the object of the ESC's far-reaching prevention programme. Concurrent imaging of metabolic and electric signals in the heart Cardiac rhythm disorders can result from disturbances in cardiac metabolism. These metabolic changes are tightly linked with specific cardiac electrophysiology (CEP) abnormalities, such as depressed excitability, impaired intra- and extracellular conductivities, wave propagation block, and alteration of conduction velocity, action potential amplitude, and duration. Canadian cardiology team clears the way for lifesaving breast cancer treatment A team of Canadian cardiologists, in collaboration with oncologists, are playing an important role in the war against breast cancer Dr. Michael McDonald told the Canadian Cardiovascular Congress 2009, co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society. 'Superobesity,' chronic disease burden associated with risk of death following bariatric surgery Veterans classified as superobese and those with a higher chronic disease burden appear more likely to die within a year of having bariatric surgery, according to a report in the October issue of Archives of Surgery, one of the JAMA/Archives journals. Thyroid surgery safe for older patients, study finds Thyroid surgery is safe for older patients, say physicians who found only slight differences in rates of complications and hospital readmissions in a multi-year study. New mathematical model more accurately diagnoses acute heart failure in emergency rooms Researchers at St. Michael's Hospital have developed the first mathematical model in cardiology and emergency medicine to more quickly and reliably diagnose acute heart failure (AHF) in emergency room patients. Cost Effectiveness of Blood Pressure Device Evaluated A study conducted by the University of Rochester Medical Center (URMC) demonstrates that, for certain patient populations, an experimental device that lowers blood pressure may be a cost effective treatment. The implantable device, called Rheos, is in advanced stages of testing for individuals with drug resistant hypertension. More Heart Failure Current Events and Heart Failure News Articles |
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