During foreplay, the blood pressure and heart rate increase mildly. The greatest increases occur during the 10-15 seconds of orgasm, with rapid return to baseline thereafter. Men and women have similar cardiac responses to sexual activity.
In a study of 5559 instances of sudden death, 34 (0.6%) reportedly occurred during sexual intercourse. Two other studies also showed low rates. Of these subjects, 82%-93% were men and the majority (75%) were having extramarital sexual activity with a younger partner, in an unfamiliar setting and/or after excessive food and alcohol consumption. The increase in absolute risk of sudden death associated with one hour of additional sexual activity per week is estimated to be <1 per 10,000 person-years.
Here is good advice:
1. If you can exercise without angina and pass an exercise stress test, you can safely have sex.
2. Increasing exercise and controlling weight, blood pressure and other risk factor for cardiac disease also help your ability to have safe sexual activity.
3. If you have had a heart attack, cardiac rehabilitation reduces further risk or complications with sexual activity.
4. Do not take any performance-enhancing medication without talking with your physician. Some of them can cause a drop in blood pressure if you are on cardiac medication.