Canadian Journal of Cardiology

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



      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.


      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.


      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.


      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.



      La baisse de l’activité sexuelle (AS) est un problème très répandu chez les patients ayant une maladie cardiovasculaire (MCV). Malgré l’existence de données probantes sur l’efficacité de la réadaptation cardiaque (RC) pour améliorer les paramètres physiques et la qualité de vie générale, les effets de la RC sur l’AS restent mal cernés. Dans cette revue systématique, nous avons évalué l’association entre la participation à un programme de RC et les résultats de celui-ci sur l’AS chez des adultes atteints d’une MCV.


      Une recherche systématique a été effectuée en janvier 2018 dans les bases de données électroniques (MEDLINE, PsycINFO, EMBASE, CINAHL). Les études originales qui comparaient la participation à un programme de RC et l’absence de participation à un tel programme chez des adultes âgés de 18 ans et plus ayant reçu un diagnostic de MCV et qui faisaient également état du résultat sur l’AS ont été incluses. Une synthèse narrative a été réalisée, car les données ne permettaient pas de faire une méta-analyse.


      Quatorze études ont été retenues : 6 essais contrôlés avec répartition aléatoire, 5 essais contrôlés sans répartition aléatoire et 3 études de cohortes prospectives. Tous les programmes de RC comportaient un volet d’activité physique et 4 possédaient un volet axé sur l’AS. Sept études faisaient état d’une amélioration significative de l’AS dans le groupe RC, une étude rapportait un effet négatif important et, dans les 11 autres études, la différence n’était pas significative.


      L’effet de la RC sur les paramètres d’évaluation liés à l’AS généralement rapporté dans les études était soit équivoque, soit positif. La RC s’est révélée prometteuse jusqu’à un certain point pour améliorer le fonctionnement sexuel et la fréquence des rapports, avec toutefois des résultats mitigés sur le plan de la reprise des relations sexuelles et de la satisfaction à cet égard. En conclusion, il reste à déterminer si la RC améliore de façon systématique l’AS chez les adultes atteints d’une MCV, mais ces données semblent indiquer que des recherches plus poussées dans ce domaine pourraient être justifiées.
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