Returning to usual levels of sexual activity a few months after a heart attack is linked to improved survival, a new study suggests.

Researchers looked at whether resumption of sexual activity shortly after hospitalisation for a first heart attack was associated with survival over more than two decades.

They found that maintaining or increasing the frequency of sexual activity within the first six months after a heart attack was associated with a 35% lower risk of death compared with abstaining or reducing the frequency of sexual activity.

The scientists suggest the benefit linked with maintaining or increasing the frequency of sexual activity was mostly attributable to a reduction in non-cardiovascular mortality such as cancer.

Resumption of sexual activity soon after a heart attack may be a part of one's self-perception as a healthy, functioning, young and energetic person

Professor Yariv Gerber of Tel Aviv University, Israel, said: “Sexuality and sexual activity are markers of wellbeing.

“Resumption of sexual activity soon after a heart attack may be a part of one’s self-perception as a healthy, functioning, young and energetic person.

“This may lead to a healthier lifestyle generally.”

Previous research suggests sexual activity is a form of physical exercise, increasing heart rate and blood pressure.

Sudden vigorous physical exertion can sometimes lead to a heart attack, but despite this triggering effect, regular physical activity reduces the long-term risk of adverse heart-related outcomes, according to the researchers.

Similarly, episodic sexual activity can sometimes trigger cardiac events, but studies have shown this risk is lower in individuals who exercise regularly.

Researchers obtained data from the Israel Study of First Acute Myocardial Infarction, and the study included 495 sexually active patients aged 65 years or under who were admitted to hospital for a first heart attack in 1992 to 1993.

The average age was 53 years and 90% were men.

Information about the frequency of sexual activity was collected by interview at two stages – during initial hospitalisation, and three to six months afterwards.

Based on the frequency reported at the two interviews, participants were classified into two groups – those who abstained from sexual activity or decreased its frequency following the heart attack (47%), and those who maintained or increased its frequency after the heart attack (53%).

During a median follow-up of 22 years, 211 (43%) patients died, the study published in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology, found.

When comparing the risk of death between the two groups, the researchers accounted for baseline differences in other characteristics which could also predict mortality, such as socioeconomic status, depression, physical activity, obesity, self-rated health, and the severity of the heart attack.

They found that maintaining or increasing the frequency of sexual activity within the first six months after a heart attack was associated with a 35% lower risk of death.

Prof Gerber said: “Improved physical fitness, stronger spouse relations, and a mental ability to ‘bounce back’ from the initial shock of the event within a few months are among the possible explanations for the survival benefit observed among the maintained/increased group.”

“On the other hand, patients who perceive their health as poor might be less likely to start having sex again.

“They may also be less likely to adhere to cancer screening tests and other prevention practices during follow-up.

“This may explain the strong inverse association between resumption of sexual activity and cancer mortality that was seen in our study.”

Prof Gerber highlighted a number of limitations of the study, including that the low proportion of women and relatively young age of participants may limit the generalisability of the results to females and older individuals.

He added that this was an observational study and causation cannot be assumed.