Abstract
Introduction: Sexual frequency is an important indicator of overall health and plays a vital role in various health conditions. There is a wide array of physical and mental health benefits that are associated with sexual activity. Cardiovascular disease (CVD) is the most common cause of mortality each year. The purpose of this study was to explore a connection between CVD and all-cause mortality and if sexual frequency modified this effect. Methods: For this study, we utilized the 2005-2016 National Health and Nutrition Examination Survey (NHANES) and the NDI-linked all-cause mortality data of US adults aged between 20-59 years. Low sexual frequency was determined by individuals who had sexual intercourse less than once a month. Survival curves showed the combined effect of sexual frequency and all-cause mortality, using the Kaplan-Meier product-limit method to estimate the percent survival of the subject at each point in time. Results: For all-cause mortality, the unadjusted hazard ratio (HR) for CVD to no CVD was HR = 5.1. The adjusted HR was elevated HR = 2.3 among individuals who had CVD and low sexual frequency but close to 1.0 among individuals who had a history of CVD but reported moderate-to-high/high sexual frequency after adjusting for demographic and health variables. Conclusions: From a nationally representative sample, our study was the first to demonstrate, in unadjusted and adjusted models, that CVD and low sexual frequency combined have worse outcomes than CVD alone. This finding indicates the need to conduct a sexual history among individuals with CVD or other chronic diseases.