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Epifanio MS, La Grutta S, Alfano P, Marcantonio S, Piombo MA, Ammirata M, Rebulla E, Grassi S, Leone S, Clemenza F, Girgenti R, Lo Baido R, Di Blasi M. Sexual Satisfaction and Quality of Life in Cardiovascular Patients: The Mediating Role of Anxiety. Healthcare (Basel) 2023; 11:healthcare11030290. [PMID: 36766865 PMCID: PMC9913900 DOI: 10.3390/healthcare11030290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Cardiovascular diseases represent one of the most important problems for public health. Research indicates that elderly patients consider sexual satisfaction as a fundamental aspect of their quality of life and a better sexual function is related to higher general wellbeing. OBJECTIVE The main objective of this study was to investigate the mediating role of anxiety and depression in the relationship between quality of life and sexual satisfaction in cardiovascular (CVD) patients. METHODS The sample comprised 128 adult patients, males and females, hospitalized in a Cardiology Rehabilitation clinical center. To collect data, the following were used: a demographic information sheet, the left ventricular ejection fraction (EF) to evaluate cardiac function, cardiovascular diagnosis type, the HADS scale to evaluate anxiety and depression states, a test for sexual satisfaction evaluation (SAS) and the SF-36 survey to measure quality of life. RESULTS The results indicated that only SF-36 physical health is indirectly related to SAS through its relationship with anxiety. CONCLUSION A mediating model was proposed to explore the underlying association between sexual satisfaction and quality of life. We recommend investigating perceived general health and sexuality as clinical indicators for therapeutic decisions and risk evaluation for the management of cardiovascular diseases.
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Affiliation(s)
- Maria Stella Epifanio
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy
| | - Sabina La Grutta
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy
| | - Pietro Alfano
- Institute of Translational Pharmacology (IFT), National Research Council of Italy, 90146 Palermo, Italy
- Correspondence:
| | - Salvatore Marcantonio
- Quality, Planning and Strategic Support Area, University of Palermo, Piazza Marina 61, 90133 Palermo, Italy
| | - Marco Andrea Piombo
- Department of Psychology “Renzo Canestrari”, Alma Mater Studiorum, University of Bologna, 40127 Bologna, Italy
| | - Martina Ammirata
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy
| | - Eduardo Rebulla
- Division of Cardiology, Candela Clinic, 90141 Palermo, Italy
| | - Silvia Grassi
- Division of Cardiology, Candela Clinic, 90141 Palermo, Italy
| | - Simona Leone
- Division of Cardiology, Candela Clinic, 90141 Palermo, Italy
| | - Francesco Clemenza
- Cardiology Operating Unit, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), 90127 Palermo, Italy
| | - Rosario Girgenti
- Clinical Psychology Service, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), 90127 Palermo, Italy
| | - Rosa Lo Baido
- Section of Psychiatry, Experimental Biomedicine, Clinical Neuroscience and Advanced Diagnostic Department (BiND), Palermo University, 90127 Palermo, Italy
| | - Maria Di Blasi
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy
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Beerepoot S, Luesken SWM, Huisman M, Deeg DJH. Enjoyment of Sexuality and Longevity in Late Midlife and Older Adults: The Longitudinal Ageing Study Amsterdam. J Appl Gerontol 2022; 41:1615-1624. [PMID: 35324364 PMCID: PMC9082964 DOI: 10.1177/07334648221078852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Sexual well-being refers to the evaluation of one’s sexuality. We examined the association of enjoyment of sexuality with longevity and the moderating role of perceived importance of sexuality in this association. In the population-based Longitudinal Ageing Study Amsterdam, the survival of initially 55–84-year-olds was followed during 27 years. Complete data were available for 1042 participants (45.3%). Analyses were adjusted for health-related and psychosocial covariates. 60% of the participants experienced their sexuality as enjoyable and 44% as important. Enjoyment of sexuality was weakly, positively associated with longevity (B[CI] = 0.29[-0.004;0.58]). Perceived importance modified this association: only in those who perceived sexuality as important, the association between enjoyment and longevity was statistically significant (B[CI] = 0.78[0.29;1.27]). Positive affect, functional limitations, emotional loneliness, self-rated health, sense of mastery and alcohol consumption accounted for 35% of the latter association. Interventions may target older adults who perceive sexuality as important but not enjoyable.
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Affiliation(s)
- Shanice Beerepoot
- Department of Epidemiology & Data Science and the Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Suzanne W M Luesken
- Department of Epidemiology & Data Science and the Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Martijn Huisman
- Department of Epidemiology & Data Science and the Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Department of Sociology, VU University, Amsterdam, The Netherlands
| | - Dorly J H Deeg
- Department of Epidemiology & Data Science and the Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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Interactions between erectile dysfunction, cardiovascular disease and cardiovascular drugs. Nat Rev Cardiol 2022; 19:59-74. [PMID: 34331033 DOI: 10.1038/s41569-021-00593-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 02/06/2023]
Abstract
Sexual health has a fundamental role in overall health and well-being, and a healthy and dynamic sex life can make an important contribution to a good quality of life. Sexual dysfunction, and especially erectile dysfunction (ED) in men, is highly prevalent in patients with cardiovascular disease (CVD). CVD and ED have shared risk factors and pathophysiological links, such as endothelial dysfunction, inflammation and low plasma testosterone levels. ED has been shown to be an independent and early harbinger of future CVD events, providing an important window to initiate preventive measures. Therefore, screening and diagnosing ED is essential for the primary and secondary prevention of CVD because the assessment of ED offers an easy and low-cost prognostic tool that is an alternative to other investigational cardiovascular biomarkers. Moreover, ED is a major contributing factor to the discontinuation of, or poor adherence to, cardiovascular therapy. Cardiovascular drugs have divergent effects on erectile function, with diuretics and β-blockers having the worst profiles, and renin-angiotensin-aldosterone system inhibitors and nebivolol having the best profiles. Pharmacological treatment of ED has an equivocal effect on the risk of CVD, suggesting a complex interaction between ED and drugs for CVD. In this Review, we discuss how sexual function could be incorporated into the patient history taken by physicians treating individuals with CVD, not merely as part of the diagnostic work-up but as a means to pursue tangible and essential benefits in quality of life and cardiovascular outcomes.
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Maas R, Rodionov RN. Phosphodiesterase-5 Inhibitors and Survival in Men With Coronary Artery Disease. J Am Coll Cardiol 2021; 77:1551-1553. [PMID: 33766261 DOI: 10.1016/j.jacc.2021.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 01/01/2023]
Affiliation(s)
- Renke Maas
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Roman N Rodionov
- Division of Angiology, Department of Internal Medicine III, University Center for Vascular Medicine, Technische Universität Dresden, Dresden, Germany; College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
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Cohen G, Nevo D, Hasin T, Benyamini Y, Goldbourt U, Gerber Y. Resumption of sexual activity after acute myocardial infarction and long-term survival. Eur J Prev Cardiol 2020; 29:304-311. [PMID: 33624045 DOI: 10.1093/eurjpc/zwaa011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 07/08/2020] [Accepted: 07/13/2020] [Indexed: 11/14/2022]
Abstract
AIMS Sexual activity is an important factor in the overall quality of life. We examined whether resumption of sexual activity frequency within the first few months after myocardial infarction (MI) is associated with long-term survival. METHODS AND RESULTS Sexually active patients aged ≤65 years (n = 495; median age, 53 years), drawn from the longitudinal Israel Study of First Acute Myocardial Infarction, were interviewed during the index hospitalization (1992-93) and after 3-6 months. Resumption of sexual activity was defined as abstaining/decreasing or maintaining/increasing according to self-reported frequency post- vs. pre-MI. Patients were followed for all-cause and cause-specific mortality through national registries. A propensity score for sexual activity resumption was calculated, based on which inverse probability weighted Cox models were constructed to examine associations. Patients who maintained/increased frequency [n = 263 (53%)] were more likely to be of higher socioeconomic status and to express lower levels of depression than their abstained/decreased counterparts. In the propensity score-weighted synthetic sample, the distribution of measured baseline covariates was similar across exposure categories. During a median follow-up of 22 years, 211 (43%) patients died. Maintaining/increasing sexual activity frequency was inversely associated with all-cause mortality [hazard ratio (HR) 0.65, 95% confidence interval (CI) 0.48-0.88], compared with abstaining/reducing. The inverse association was more robust for non-cardiovascular mortality (HR 0.56, 95% CI 0.36-0.85) than cardiovascular mortality (HR 0.90, 95% CI 0.53-1.51). CONCLUSIONS Resumption of sexual activity frequency within the first months after MI was strongly associated with improved long-term survival, highlighting the need for sexual counselling shortly after MI.
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Affiliation(s)
- Gali Cohen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.,Stanley Steyer Institute for Cancer Epidemiology and Research, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Nevo
- Department of Statistics and Operations Research, School of Mathematical Sciences, Raymond and Beverly Sackler Faculty of Exact Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Tal Hasin
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Yael Benyamini
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Uri Goldbourt
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Yariv Gerber
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.,Stanley Steyer Institute for Cancer Epidemiology and Research, Tel Aviv University, Tel Aviv, Israel
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mut. [Not Available]. MMW Fortschr Med 2019; 161:9. [PMID: 31494902 DOI: 10.1007/s15006-019-0819-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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