Physical activity conveys many health benefits including a reduction in the chances of developing cardiovascular disease.  However, it has also been suggested that physical activity, as well as others acute exposures such as sexual activity and psychological stress, can actually trigger acute cardiac events.

Dahabreh and Paulus performed a meta-analysis of 14 studies (10 investigating episodic physical activity, 3 investigating sexual activity, and 1 study investigating both exposures) to examine this relationship further.  Of note both episodic physical and sexual activity were associated with an increase in the risk of myocardial infarction (RR=3.45 and 2.70, respectively).  Episodic physical activity was also associated with an increased risk of sudden cardiac death (RR=4.98).  Importantly, regular exercise was found to attenuate the risk of episodic physical activity (p<0.001) and sexual activity (P=.04) to cause MI.  For every additional episode per week that an individual regularly took exercise, the RR for MI decreased by approximately 45%, and RR for sudden cardiac death decreased by 30%.

Conclusions:

Episodic physical and sexual activity are significantly associated with myocardial infarction, however this association is attenuated among persons who take regular exercise.

• Dahabreh IJ and Paulus JK.  Association of Episodic Physical and Sexual Activity With Triggering of Acute Cardiac Events.  JAMA 2011; 305:1225-1233.