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The Influence of Comorbidities, Risk Factors, and Medications on Sexual Activity in Individuals Aged 40 to 59 Years With and Without Cardiac Conditions: US National Health and Nutrition Examination Survey, 2011 to 2012

Steinke, Elaine, E., PhD, APRN, CNS-BC, FAHA, FAAN; Mosack, Victoria, PhD, APRN, PMHCNS-BC; Hill, Twyla, J., PhD

The Journal of Cardiovascular Nursing: March/April 2018 - Volume 33 - Issue 2 - p 118–125
doi: 10.1097/JCN.0000000000000433
ARTICLES: Prevention

Background: Sexual activity is increasingly recognized as an important aspect of quality of life for many individuals with cardiovascular disease, although less is known about the factors contributing to sexual functioning in younger adults.

Objective: This study examined factors influencing sexual activity in individuals aged 40 to 59 years, comparing those reporting a cardiac condition with those without a cardiac condition, in a national population–based sample.

Methods: The data were derived from the 2011 to 2012 National Health and Nutrition Examination Survey, a publicly available data set with a noninstitutionalized nationally representative sample. The sample included individuals between the ages of 40 and 59 years (N = 1741) who completed relevant items related to cardiovascular disease, cardiovascular risk factors, comorbidities, cardiac symptoms, sexual activity, and medication use. Recommended weighting was applied, and the data were analyzed using χ 2 and logistic regression.

Results: Overall, 94% of the sample reported sexual activity, although those with coronary artery disease, angina, and myocardial infarction engaged in significantly less sexual activity. Individuals who smoked; had a weight problem, depression, or lung problems; or experienced symptoms of shortness of breath or chest pain with exertion reported less sexual activity. Medications negatively affecting sexual function were central α agonists, potassium sparing diuretics, and antilipidemic agents. Predictors of less sexual activity were smoking, chest pain walking uphill, and weight problems. Unexpectedly more reported, sexual activity was predicted by one or more cardiac conditions.

Conclusion: In men and women ages 40 to 59 years, certain cardiac conditions, risk factors, comorbidities, symptoms, and medications negatively affected sexual activity, illustrating the need for sexual assessment and counseling to support sexual quality of life.

Elaine E. Steinke, PhD, APRN, CNS-BC, FAHA, FAAN Professor, School of Nursing, Wichita State University, Kansas.

Victoria Mosack, PhD, APRN, PMHCNS-BC Associate Professor, School of Nursing, Wichita State University, Kansas.

Twyla J. Hill, PhD Professor and Statistician, Department of Sociology, Wichita State University, Kansas.

The authors have no funding or conflicts of interest to disclose.

Correspondence Elaine E. Steinke, PhD, APRN, CNS-BC, FAHA, FAAN, School of Nursing, Wichita State University, 1845 Fairmount, Wichita, KS 67260–0041 (

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