Sexual activity and cardiovascular risk

With the recent advent and expanding use of potencyenhancing treatments, including phosphodiesterase (PDE) type 5 inhibitors, attention has focused on the potential health hazards of sexual activity[1]. Interest in this issue was heightened by reports of acute myocardial infarction (MI) allegedly associated with the use of the PDE5 inhibitor sildenafil citrate (Viagra®; Pfizer Inc., New York, U.S.A.)[2]. However, a subsequent British prescription event monitoring study found no evidence for a higher incidence of fatal MI or coronary heart disease (CHD) among more than 5600 men taking sildenafil[3]. Nevertheless, a U.S. panel of cardiologists released a consensus statement establishing clinical recommendations for the use of sildenafil in patients with cardiovascular disease (CVD)[4]. Irrespective of their erectile dysfunction (ED) treatment regimens, patients with CVD incur a distinct, albeit slight, risk for sudden death during sexual activity[1]. The present review considers epidemiological evidence regarding the health risks (and benefits) of sexual activity in men, as well as guidelines for recognizing and managing these risks in clinical practice. Erectile dysfunction in perspective