Archive for the ‘heart disease’ Category

To Your Good Health. Give Me a High Fi-Ber!

September 30, 2014

We are trying to lead a healthy lifestyle. Doctors advise us to avoid processed food, take vitamins, and to exercise on a regular basis. Part of leading a healthy life style includes including plenty of fiber in our diets. Most men and women consume only 15gms of fiber a day. The daily recommendation for men is 35gms daily of fiber and for women the recommendation is 25gms. You can increase your fiber by 7gms a day by increasing vegetable and fruit consumption by two portions a day.

Good sources of fiber include what, rice, oats, barley and beans. Also fiber can be found in nuts and seeds, carrots, cauliflower, citrus fruits, strawberries and apples.

There’s no shortage of research showing how fiber may boost your health. Some of its top potential benefits include:

  • Blood sugar control: Soluble fiber may help to slow your body’s breakdown of carbohydrates and the absorption of sugar, helping with blood sugar control.
  • Heart health: An inverse association has been found between fiber intake and heart attack, and research shows that those eating a high-fiber diet have a 40 percent lower risk of heart disease.
  • Stroke: Researchers have found that for every seven-grams more fiber you consume on a daily basis, your stroke risk is decreased by 7 percent.
  • Weight loss and management: Fiber supplements have been shown to enhance weight loss among obese people,3 likely because fiber increases feelings of fullness.
  • Skin health: Fiber, particularly psyllium husk, may help move yeast and fungus out of your body, preventing them from being excreted through your skin where they could trigger acne or rashes.
  • Diverticulitis: Dietary fiber (especially insoluble) may reduce your risk of diverticulitis – an inflammation of polyps in your intestine – by 40 percent.
  • Hemorrhoids: A high-fiber diet may lower your risk of hemorrhoids.
  • Irritable bowel syndrome (IBS): Fiber may provide some relief from IBS.
  • Gallstones and kidney stones: A high-fiber diet may reduce the risk of gallstones and kidney stones, likely because of its ability to help regulate blood sugar.

Bottom Line: High-fiber foods are good for your health. But adding too much fiber too quickly can promote intestinal gas, abdominal bloating and cramping. Increase fiber in your diet gradually over a period of a few weeks. This allows the natural bacteria in your digestive system to adjust to the change. Finally, drink plenty of water. Fiber works best when it absorbs water, making your stool soft and bulky.

Modified from article by Dr. Maureen Hecker-Rodriguez from Touro Infirmary

Erectile Dysfunction and Heart Disease

September 6, 2014

There is no doubt that there is a connection between heart disease and erectile dysfunction or ED. The blood supply to the penis is through blood vessels that are less than half the size of the blood vessels to the penis and therefore are problems with erections are often preceded prior to problems with the heart.

Patients with heart disease who have severe erectile dysfunction should receive more ‘aggressive’ cardiac rehab care because they have such a poor prognosis relative to other patients with more normal sexual function, researchers reported at the European Society of Cardiology annual scientific meeting this week.

A study looking at the outcomes of 373 patients undergoing cardiac rehabilitation over 30 months found that the 62 patients with severe erectile dysfunction had a three fold higher risk of adverse cardiac events and death than the rest of the patients, even after accounting for their greater risk from other factors.

The researchers concluded: ‘Presence and severity of erectile dysfunction is a strong determinant of coronary heart disease prognosis, independently of age, functional capacity and other cardiovascular risk factors.
Routine assessment of sexual function is therefore warranted in cardiac rehabilitation programs and presence of severe erectile dysfunction may determine a more aggressive and holistic approach to cardiac rehabilitation in coronary heart disease.’

In another presentation, researchers found patients with chronic heart failure need to undertake high-intensity aerobic exercise to help regain sexual function.
Among 20 patients with stable heart failure, aged on average 53 years, a 12-week high-intensity interval training program led to increased erectile function, desire and sexual satisfaction as well as improved quality of life, whereas a moderate intensity continuous training program only improved patients’ quality of life.

Bottom Lline The researchers concluded: In patients with chronic heart failure, only high intensity aerobic training improved sexual function, while quality of life improved with both intensities of exercise.

Low testosterone in men shouldn’t be ignored

July 28, 2014

Low testosterone in men shouldn’t be ignored

Posted on July 11, 2014 at 5:21 PM
Meg Farris / Eyewitness News
Email: mfarris@wwltv.com | Twitter: @megfarriswwl

NEW ORLEANS – Beginning around the age of 30, men start losing one percent of an important hormone each year.

And doctors say it is important to replace it for quality of life and long term health.
Jerry Tolbert played basketball in the Air Force. In golf, he usually hits a few strokes over par, but in his mid 50s, something changed.

“As men we don’t like to talk about those things. Just seems like it’s something about that you keep to yourself,” said Tolbert.

Jerry was going through andropause. His testosterone levels were declining, like menopause in women. The hormone testosterone is responsible for sex drive and performance, muscle and bone mass, energy, mood, thinking and metabolism, helping decrease fat storage. So when he didn’t feel like himself, he turned to urologist Dr. Neil Baum.
“If your testosterone level is low, it is good medicine to raise it to normal,” explained Dr. Baum, a urologist at Touro. He says with other medical conditions, such as blood pressure, glucose and thyroid levels, doctors don’t hesitate to help patients bring those to normal.

Dr. Baum says when levels of testosterone drop, men can fall asleep after meals more easily, have low sex drive, energy and motivation, along with muscle and fitness loss and mood changes such as irritability and depression.

So with a simple blood test to diagnose low-T along with symptoms, he uses injections or creams or even tiny pellet implants to replace what the body no longer makes.

Dr. Baum wants to make it abundantly clear, this is not about taking a lot of testosterone to make you super human like some of the professional athletes do. This is simply about replacing what your body no longer makes to bring you up to normal.

He says a recent study raising concerns about testosterone replacement and risks for heart attacks and strokes, was poorly done, even including women in the study.

“The study is really flawed from so many different areas and now a new study came out that demonstrates that replacing testosterone improves the cardiac function improves, decreases the risk of stroke and it may be cardio-protective instead of cardio-dangerous,” he added.

Now at 67 years old, Jerry feels normal and his clothes fit better.

“I had this midriff bulge, that’s going away now. It’s not as bad as it was,” said Tolbert about his midsection since he began hormone replacement therapy.
Going years with low testosterone can increase risk for hip and spine fractures, diabetes and heart disease as well as cognitive declines, loss of sex drive, sexual performance and overall energy.

Doctors do not recommend oral hormone replacement at all, or replacement for men not finished having children.

Recent Study Does Not Indicate Testosterone Use Doesn’t Increase Heart Risk

July 7, 2014

A few months ago an article appeared in the Journal of the American Medical Association (JAMA) that implicated testosterone as a cause of heart disease and stroke. But critics including several hundred physicians have attacked the study noting that among other things, the study including over 100 women among the 1,132 subjects studied. Over 25 international medical groups have demanded that JAMA retract the article.

A new study now points out that testosterone therapy didn’t increase the risk of heart attack, contrary to the JAMA study, and that it even lowered the risk of heart attack by about 30%.
In the latest study, published online in the Annals of Pharmacotherapy, researchers at the University of Texas Medical Branch used a national Medicare sample and compared the records of 6,355 men who had at least one testosterone injection between 1997 and 2005, with 19,065 non-testosterone users. The testosterone users were no more likely to have a myocardial infarction than the nonusers during the period, according to the study.

The researchers also ranked the subjects based on their predicted risk of heart attack for other reasons. For men in the quarter with the highest risk, the use of testosterone cut that risk by roughly 30%.

The latest study only at men receiving testosterone injections, not those using pills, patches or gels, and couldn’t assess what other medications the men were taking. Men typically lose testosterone as they age, and some conditions can cause a steep drop in levels earlier, leading to osteoporosis which increases the risk of hip and spine fractures, sexual dysfunction, loss of muscle tone, fatigue, diabetes and other health problems. Proponents say restoring normal levels can alleviate those issues.

Bottom Line: Testosterone deficiency or low T affects millions of American men. The diagnosis is easily made with a history of decreased libido, decreased sexual performance, loss of muscle mass and loss of energy or fatigue. The diagnosis is easily made with a simple blood test and can be helped with testosterone replacement therapy. For more information on testosterone deficiency speak to your doctor.

What You Need To Know About Low T (Testosterone) and Heart Disease

March 27, 2014

I have received dozens of calls from men who are concerned about the recent study that reports that testosterone replacement therapy increases the risk of heart attacks and strokes. This blog is intended to clarify some of the misinformation that is attracting so much media attention. The Androgen Study Group, a large group of physicians and researchers of which I am a member, is calling for the retraction of the paper that appeared in the Journal of American Medical Association linking testosterone and cardiovascular risks — data that its authors of the paper in the journal are standing firmly behind.

In a letter to Howard Bauchner, MD, editor-in-chief of the Journal of the American Medical Association, members of the group — formed in response to the paper and comprised of more than 125 doctors — said the study’s credibility was compromised by at least two corrections and should be pulled from the journal.
A close friend and colleague, Dr. Abraham Morgentalker pointed out the there’s no misconduct, no one faked any data, it’s just sloppy. The group called it “gross data mismanagement.”

The paper, published in JAMA in November by Michael Ho, MD, PhD, of the Eastern Colorado VA, and colleagues, found that testosterone therapy was associated with a greater risk of death, heart attack, and stroke in male veterans who’d had coronary angiography. (If the men were having coronary angiography, it stands to reason that they already had some heart disease or they wouldn’t have been subjected to this invasive procedure)

But two corrections have since been published. The first, in the Jan. 15 issue, was a clarification that the results were based on “estimates” and not raw data.

The second, which Morgentaler and colleagues focus on in their letter to the editor of the journal, involved reclassivication of patient who were excluded from the study. More than 1,000 excluded patients were assigned to different categories of exclusion, including 100 who were women!

The authors included almost 10% women in an all-male study, so why should we believe any of the other data? The Androgen Study Group points out that the data were so off that it’s hard to believe the data for the entire study are accurate.

However, Ho and colleagues said they “stand firmly by the results of our study,” noting that the overall number of excluded patients remains the same, as does the total number of included patients, and the main results of the study were not changed.

The study group said that these claims run contrary to 40 years’ worth of research on testosterone, which suggests that the hormone has some beneficial effects in certain heart patients.

But the testosterone therapy field has garnered much media attention for its financial relationships with industry. Several articles in the New York Times, including one on the marketing of “Low T”, another on the selling of testosterone gels, and an editorial, have questioned the potential overselling of the therapy.

It is true that several members of the Androgen Study Group, myself included, have relationships with testosterone drug makers, such as AbbVie, Watson, and Endo Pharmaceuticals.

It is my opinion that men who are symptomatic for low testosterone and have complaints such as lethargy, decreased libido, loss of muscle mass, and decrease in erections or potency AND who have a documented decrease in the blood level of testosterone, are good candidates for hormone replacement therapy. These men who are going to receive testosterone should have a normal digital rectal exam and a normal PSA test if they are less than 75 years of age.

Bottom Line: Low testosterone has effects that impact a man’s quality of life. If a man has symptoms of low T and a documented decrease in the blood testosterone level, he should speak to his physician about testosterone replacement therapy.

Good News For the Bedroom-Sex Is Heart Healthy

February 28, 2014

Certainly there are some men who worry that having sexual intercourse may cause a heart attack. Or men who have had a heart attack are at risk for another attack if they have sexual intercourse. Well, there’s good news for men. A recent study from England shows men who indulge in regular lovemaking are up to 45 per cent less likely to develop life-threatening heart conditions than men who have sex once a month or less.

The study, of over 1,000 men, shows sex appears to have a protective effect on the male heart but did not examine whether women benefit too.

Now the American researchers who carried out the investigation are calling for doctors to screen men for sexual activity when assessing their risk of heart disease.

Every year, around 270,000 people in Britain suffer a heart attack, and coronary disease remains Britain’s biggest killer.

Although sex has long been regarded as good for physical and mental health, there has been little scientific evidence to show the full benefits that frequent intercourse can have on major illnesses such as heart disease.

In the latest study, scientists at the New England Research Institute in Massachusetts, tracked the sexual activity of men aged between 40 and 70 who were taking part in a long-term project called the Massachusetts Male Ageing Study, which began back in 1987.
At regular points over a 16-year period, each man was questioned on how often they had sex and then checked for signs of heart disease.
Researchers took into account other risk factors, such as their age, weight, blood pressure and cholesterol levels.

The results, published in the American Journal of Cardiology, showed men who made love at least twice a week were much less likely to have heart disease than those whose sexual encounters were limited to once a month or less.

In a report on their findings, researchers said the benefits of sex could be due to both the physical and emotional effects on the body.
Men with the desire for frequent sexual activity and who are able to engage in it are likely to be healthier.

But sex in some forms has a physical activity component that might directly serve to protect cardiovascular health.

Also, men who have frequent sex might be more likely to be in a supportive intimate relationship and this might improve health through stress reduction and social support.

And there’s a benefit for the women in your life as well: Regular sex can even boost a woman’s sense of smell by triggering the release of a hormone called prolactin, according to scientists at Calgary University in Canada. This may be a mechanism to help mums bond with their new babies.

Bottom Line: No one disagrees that sex is good and sex might just be good for your health as well. So men, if you are looking for a reason to have regular sex, tell your partner to do it for your health and her health as well. It’s a twofer!

http://www.telegraph.co.uk/health/healthnews/6950548/Having-sex-twice-a-week-reduces-chance-of-heart-attack-by-half.html

Testosterone and Heart Disease – Facts & Caveats

January 30, 2014

I have received numerous calls from men who have symptoms of low testosterone, a documented decrease in their serum testosterone level, and who are receiving testosterone replacement therapy regarding a study that recently appeared in PLOS One.*

Let’s look at some facts. The human body is always trying to achieve homeostasis which is defined as “the ability or tendency of an organism or cell to maintain internal equilibrium by adjusting its physiological processes.” What does this mean? It means that the body is always trying to stay normal without deviations from the norm. For example, if a man drinks too much water, the kidneys will increase the excretion of water. If a man is dehydrated, the kidneys will try and conserve water to prevent the problems associated with dehydration. If a man has diabetes, the doctor will recommend a treatment to lower the blood sugar. If a man has high blood pressure, the doctor will recommend dietary changes, exercise, and perhaps medication to lower the blood pressure. If a man has anemia or a low blood count because of iron deficiency, the doctor will prescribe iron supplements. If a man has a deficiency in vitamin D, the doctor will recommend increasing the consumption of this necessary vitamin. These actions are what we do every day; we attempt to achieve a normal equilibrium in the body as this is the best way to restore and maintain health.

This same reasoning applies to men who are deficient in testosterone. Testosterone is a necessary hormone produced in the testicles that is responsible for a man’s sex drive, muscle mass, energy level, bone strength, and even a man’s mood which may cause depression if the hormone is low and not returned to normal. The unstudied/published issue is what is the target value? Most experts feel that there is no absolute “correct” value, but rather treatment is targeted at relief of symptoms.

There are more than 13 million men in the United States who reportedly suffer from testosterone deficiency. For men who receive treatment, they usually report significant improvement in their symptoms. There are many conflicting reports about testosterone and heart disease. There are even studies that support that low testosterone increases the risk of heart disease and that treating the deficiency with hormone replacement therapy may be protective of heart disease.

The study recently reported a study of the risk of acute non-fatal myocardial infarction (MI) following an initial TT prescription (N = 55,593) in a large health-care database. We compared the incidence rate of MI in the 90 days following the initial prescription (post-prescription interval) with the rate in the one year prior to the initial prescription (pre-prescription interval) (post/pre).
The results of this study in all subjects revealed the rate ratio (RR) for TT prescription was 1.36. In men aged 65 years and older, the RR was 2.19 for TT prescription. The RR for TT prescription increased with age from 0.95 for men under age 55 years to 3.43 for those aged ≥75 years. In men under age 65 years, excess risk was confined to those with a prior history of heart disease.
The study summary stated that in older men, and in younger men with pre-existing diagnosed heart disease, the risk of MI following initiation of TT prescription is substantially increased.

Some comments about the study:

No follow-up or research was done on whether or not the men on testosterone therapy achieved therapeutic levels or if they stayed on treatment. It is not accurate to assume that all men treated had their testosterone levels elevated by therapy.

There is no documentation as to whether or not Endocrine Association guidelines were followed, including morning testosterone level assessments and repeating the test at least once.

In closing, a larger study in the Journal of Clinical Endocrinology and Metabolism showed that among male veterans over 40, those on testosterone had lower rates of death than those that did not. This certainly makes sense, since hypogonadism is associated with metabolic syndrome, which is associated with an increased risk of heart attack, stroke, and death.

Finally, the International Consultation in Sexual Medicine (J Sex Med 2010;7:1608) concluded that:
• Low endogenous testosterone levels correlate with an increased risk for adverse cardiovascular events
• High endogenous testosterone levels appear to be beneficially associated with decrease mortality due to all causes, including cardiovascular disease and cancer
• Testosterone supplementation in men is relatively safe in terms of cardiovascular health
• Testosterone use in men with low testosterone leads to inconsequential changes in blood pressure, glycemic control and all lipid fractions.
Bottom Line: Low testosterone levels are associated with increased atherosclerosis. Most studies confirm that administration of testosterone to men has neutral effects on cardiovascular risk factors and cardiac events. For men with a history of heart disease, a careful discussion between the doctor and patient should take place.
*http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0085805?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+plosone%2FPLoSONE+(PLOS+ONE+Alerts%3A+New+Articles)

Take Two (Aspirins) “At Night” And You Won’t Need To Call Me In the Morning

November 22, 2013

Take Two “At Night” And You Won’t Need To Call Me In the Morning

For several decades doctors have been prescribing low dose aspirin as means to protect against heart disease. Most men, including myself, take the aspirin in the morning. The researchers wanted to see if taking aspirin at night could better thin a person’s blood and potentially lower their heart attack risks.
Since the 1980s, it’s been known that cardiovascular events happen more often in the morning. Morning hours are a peak period of activity for platelets, blood cells that aid in clotting, he said. Doctors suspect that might have a hand in the increased risk of heart attacks and strokes in the morning.
Aspirin reduces the activity of platelets, and thus reduces the chance that those platelets will clot in the bloodstream and cause a heart attack or stroke, according to the findings.

Until now most doctors didn’t feel that timing of the dose, morning or evening, would matter. That’s because aspirin has a long-lasting effect on platelets, helping thin the blood for days after it is taken.
That’s why, prior to surgery, patients are told to hold off on aspirin for five to seven days, and why it continues to thin your blood even when you miss a dose.

But the Dutch researchers found that taking aspirin at bedtime reduced platelet activity more than taking it in the morning, apparently because it headed off the body’s normal morning surge in platelet activity.
The team also found that people who took aspirin at bedtime did not suffer any more stomach upset or other side effects than people who took it in the morning,.

Cardiologists who have reviewed this report suggest that until larger follow-up studies take place, people prescribed aspirin for heart problems should continue to take it whenever in the day they like.

Bottom Line: Taking baby aspirin has an affect on blood clotting mechanism and prevents heart attacks and strokes. Since there is no disadvantage to taking the medicine at night, I plan to use this medication before going to bed. If you have any questions about this recommendation, ask your doctor

Testosterone And Heart Disease – Facts and Caveats

November 6, 2013

Like most urologists, endocrinologists, and cardiologists, I have received numerous calls from men who have symptoms of low testosterone, documented decrease in their blood testosterone level, and who are receiving testosterone replacement therapy about a study that appeared in a reputable medical journal that treatment with testosterone increases the risk of heart disease. (JAMA. 2013;310(17):1829-1836. doi:10.1001/jama.2013.280386).

Let’s look at some facts. The human body is always trying to achieve homeostasis which is defined as “The ability or tendency of an organism or cell to maintain internal equilibrium by adjusting its physiological processes.” What does this mean? It means that the body is always trying to stay normal without deviations from normal. For example, if a man drinks too much water, the kidneys will increase the excretion of water. If a man is dehydrated, the kidneys will try and conserve water to prevent the problems associated with dehydration. If a man has diabetes, the doctor will recommend a treatment to lower the blood sugar. If a man has high blood pressure, the doctor will recommend dietary changes, exercise, and perhaps medication to lower the blood pressure. If a man has anemia or a low blood count because of iron deficiency, the doctor will prescribe iron supplements. If a man has a deficiency in vitamin D, then the doctor will recommend increase the consumption of this necessary vitamin. These actions are what doctors do every day; they attempt to achieve a normal equilibrium in the body as this is the best way to restore and maintain health.

This same reasoning applies to men who are deficient in testosterone. Testosterone is a necessary hormone produced in the testicles that is responsible for a man’s sex drive, muscle mass, energy level, bone strength, and even a man’s mood which may cause depression if the hormone is low and not returned to normal.

There are more than 13 million men in the United States who suffer from testosterone deficiency. For men who receive treatment, they usually report significant improvement in their symptoms. There are many conflicting reports about testosterone and heart disease. There are even studies that support that low testosterone increases the risk of heart disease and that treating the deficiency with hormone replacement therapy may be protective of heart disease.

I would like to list several comments about the study that was reported in the recent Journal of the American Medical Association (JAMA).

Of nearly 7,500 guys who did not get extra T, about 1 in 5 had bad cardiovascular outcomes, including stroke, heart attack or death. In the more than 1,200 men who got testosterone, nearly 1 in 4 had those terrible problems, an increased risk of nearly 30 percent. A truly scientific study has similar number of study patients in each group, not 7500 in the control group and 1200 in the experimental group.
The researchers concluded that taking testosterone came with an increased risk of an adverse outcome. If a statistician would add up the actual reported events in the paper for each group and divide by the numbers of men in each group. What you will find is that the absolute risk of events (death, heart attack, or a stroke) was 10% in men treated with T and 21% in men not treated. That’s right- the risk was REDUCED BY HALF in men treated with T. So a closer scrutiny needs to be done before conclusions can be made and distributed to the media.
This is obviously the opposite of what the authors reported. They come up with absolute risk rates that are not explained by any numbers in their paper. They used a complex statistical analysis to get to their conclusions without showing the numbers it was based on.

That’s not the whole story, though. Dr. Anne Cappola of the Perelman School of Medicine at the University of Pennsylvania wrote in an accompanying editorial: “The most important question is the generalizing the results of this study to the broader population of men taking testosterone ….” The take home message is not possible to generalize from this study to the entire population of men some of whom may have a low testosterone level.
That’s a very big caveat: By definition, all the men in the study were older than 60 and all had heart problems. It’s still not clear whether those same risks apply to younger, healthier guys.
“These were sick, older veterans,” Dr. Michael Ho, a cardiologist with the VA Eastern Colorado Health Care System who helped direct the study, said in an interview. Many were obese, had diabetes, and other ailments, he said. Obese men with diabetes and other co-morbid conditions are certainly at risk for heart disease, stroke, and even death.

Bottom Line: So what is a man who has low testosterone to do? I would suggest that they have a discussion with their doctor. If they have symptoms of low testosterone, and a documented level of low testosterone blood test, then the doctor and the patient have to weight the risks of testosterone replacement therapy versus the benefits. Certainly if the benefits outweigh the risks and the risks are composed of an older man with heart disease, diabetes, and other illnesses, then raising the testosterone level may not be in his best interest.

Sex After a Heart Attack

October 3, 2013

A man has a recent heart attack. He is eager to get back in the saddle and remembers the movie, Something’s Gotta Give, when Jack Nicholson, who had a recent heart attack, asks his doctor about when “his best friend” can start getting back into action. He’s told that he has to wait until he can climb two flights of stairs without shortness of breadth or chest pain. Both the man and his partner are concerned if sex trigger could another heart attack.
It is well documented that fewer than 1% of heart attacks come from having sex. It makes sense to think of sex as a form of exercise: If your doctor clears you for physical activity, you’re also likely safe for sex. Remember the two flights of stairs test.
Most men and their partners are uncomfortable broaching the topic with their doctor. Most doctors are comfortable talking about sexual intimacy and you shouldn’t avoid the topic. Often the patient is surprised — or even relieved — that the doctor raises the subject.
Similar to any type of exercise, if you begin to feel symptoms such as chest pain, abnormal shortness of breath, fatigue, dizziness, or palpitations, it definitely makes sense to slow down what you’re doing, whether you’re a man or a woman. If you’re pretty certain it’s angina, which is temporary pain or pressure in the chest when the heart doesn’t get enough oxygen, it might help to take your nitroglycerin.
The exception to that advice is for men who use medication for erectile dysfunction such as Viagra, Levitra, and Cialis — it’s dangerous to take nitroglycerin. Your blood pressure can fall to dangerously low levels, and there’s an increased risk of heart attack and even death. If you’re on an erectile dysfunction drug and have heart-related symptoms during sex, call your doctor.
Bottom Line: Sexual intimacy is important to men at all ages and includes men who have had a recent heart attack. A candid conversation will help you get back to enjoying a sexual relationship with your significant other. Talk to your doctor