Sexual activity in patients with angina.

COITAL ANGINA IS ANGINA THAT occurs during the minutes or hours following sexual activity. More than 6 million individuals in the United States experience angina pectoris. Coital angina appears to represent less than 5% of all anginal attacks. For various reasons, fewer middle aged or older women engage in sexual activity than age-matched men. Accordingly, the prevalence of coital angina is higher in men than in women. The comparative physical demands of sexual activity in men and women are unknown. Frequency of coitus diminishes with age in both women and men, especially after the onset of coronary artery disease, which occurs some 10 years later in women than in men. Coital angina is rare in patients who do not have angina during strenuous physical exertion. It is more prevalent in sedentary individuals with severe coronary artery disease who experience angina with minimal physical activity. Among these sedentary individuals, myocardial oxygen demand during coitus may exceed that during customary activities of daily living; for these individuals, sex may be a provocative test.