The Effect of Cardiac Rehabilitation Attendance on Sexual Activity Outcomes in Cardiovascular Disease Patients: A Systematic Review

Abstract

Background: Decreased sexual activity (SA) is a common problem in patients with cardiovascular disease (CVD). Although there is evidence that cardiac rehabilitation (CR) is effective in improving physical outcomes and overall quality of life, its effects on SA remain unclear. In this systematic review we assessed the association between CR attendance and SA outcomes in adults with CVD.

Methods: Electronic databases (MEDLINE, PsycINFO, EMBASE, CINAHL) were systematically searched in January 2018. Original studies that compared attendance to CR vs no attendance to CR in adults 18 years and older with diagnosed CVD that also reported on SA outcomes were included. A narrative synthesis was conducted because the data did not permit meta-analysis.

Results: Fourteen studies were identified: 6 randomized controlled trials, 5 nonrandomized controlled trials, and 3 prospective cohort studies. All CR programs included an exercise-based component and 4 included an SA-specific component. Seven studies reported a significant benefit in SA outcomes in the CR group, 1 study reported significant harm, and 11 studies reported a nonsignificant difference.

Conclusions: The effect of CR on SA outcomes was generally reported to be equivocal or positive. CR showed some promise in improving sexual functioning and frequency, with mixed results with regard to sexual resumption and satisfaction. In conclusion, it remains uncertain if CR consistently improves sexual outcomes in adults with CVD but these data suggest that further exploration might be justified.